JONATHAN M GREEN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036086603

License Status

INACTIVE

Business

First Name

JONATHAN M

Last Name

GREEN

Suffix

Business Name

JONATHAN M GREEN MD

Original Issue Date

06/30/1993

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

ST LOUIS

State

Zip

63110

County

MISSOURI

Ever Disciplined

LastModifiedDate

08/04/2008