ETHAN MARK HUCKABEE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162411

License Status

ACTIVE

Business

Title

First Name

ETHAN

Middle

MARK

Last Name

HUCKABEE

Business Name

ETHAN MARK HUCKABEE DO

Original Issue Date

09/22/2022

Effective Date

06/29/2023

Expiration Date

07/31/2026

City

JACKSON

State

Zip

49201

Ever Disciplined

LastModifiedDate

06/29/2023