JEFFREY J MODIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072166

License Status

NOT RENEWED

Business

First Name

JEFFREY J

Last Name

MODIN

Suffix

Business Name

JEFFREY J MODIN MD

Original Issue Date

12/23/1985

Effective Date

12/23/1985

Expiration Date

07/31/1990

City

ST LOUIS

State

Zip

63141

County

MISSOURI

Ever Disciplined

LastModifiedDate

09/20/2006