JOHNATHON D STEPHENS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069543

License Status

EXPIRED

Business

Title

First Name

JOHNATHON

Middle

Last Name

STEPHENS

Business Name

JOHNATHON D STEPHENS MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2021

City

JAMAICA PLAIN

State

Zip

02130

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

10/11/2022