THERESA DIANE MADDOX MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123671

License Status

INACTIVE

Business

First Name

THERESA

Middle

DIANE

Last Name

MADDOX

Suffix

Business Name

THERESA DIANE MADDOX MD

Original Issue Date

06/08/2009

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

MONTGOMERY VILLAGE

State

Zip

20886

Ever Disciplined

LastModifiedDate

06/03/2014