THEODORE J PASSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036121334

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

Last Name

PASSE

Suffix

Business Name

THEODORE J PASSE MD

Original Issue Date

06/30/2008

Effective Date

06/30/2008

Expiration Date

07/31/2011

City

SAINT PAUL

State

Zip

55101

County

MINNESOTA

Ever Disciplined

LastModifiedDate

11/14/2011