TED ANDREW MATZEN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112002

License Status

INACTIVE

Business

First Name

TED

Middle

ANDREW

Last Name

MATZEN

Suffix

Business Name

TED ANDREW MATZEN MD

Original Issue Date

08/02/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

BAXTER

State

Zip

56425

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/17/2008