MATTHEW JOHN TIEFENBRUNN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155724

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

JOHN

Last Name

TIEFENBRUNN

Business Name

MATTHEW JOHN TIEFENBRUNN MD

Original Issue Date

02/19/2021

Effective Date

02/19/2021

Expiration Date

07/31/2023

City

WASHINGTON

State

Zip

63090

Ever Disciplined

LastModifiedDate

11/30/2023