TERRY A CONKLIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112701

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

Last Name

CONKLIN

Business Name

TERRY A CONKLIN

Original Issue Date

11/29/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

SKOWHEGAN

State

Zip

04976

Ever Disciplined

LastModifiedDate

11/06/2008