BRENT RYAN DAVIDSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115254

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

RYAN

Last Name

DAVIDSON

Suffix

Business Name

BRENT RYAN DAVIDSON MD

Original Issue Date

02/16/2006

Effective Date

07/10/2008

Expiration Date

07/31/2011

City

ST LOUIS

State

Zip

63117

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/14/2011