DAVID WAYNE BOARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112569

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

WAYNE

Last Name

BOARD

Suffix

Business Name

DAVID WAYNE BOARD MD

Original Issue Date

10/22/2004

Effective Date

08/10/2020

Expiration Date

07/31/2023

City

EDEN PRAIRIE

State

Zip

55344

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

11/30/2023