MATT CESAR SLENDEBROEK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051968

License Status

CANCELLED

Business

First Name

MATT

Middle

CESAR

Last Name

SLENDEBROEK

Suffix

Business Name

MATT CESAR SLENDEBROEK MD

Original Issue Date

06/21/2006

Effective Date

06/21/2006

Expiration Date

06/20/2009

City

GRAND RAPIDS

State

Zip

49525

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006