JACK JENG-YEN FAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036049496

License Status

NOT RENEWED

Business

First Name

JACK JENG-YEN

Last Name

FAN

Business Name

JACK JENG-YEN FAN

Original Issue Date

08/28/1974

Effective Date

08/28/1974

Expiration Date

07/31/1984

City

CLAYTON

State

Zip

27520

County

NORTH CAROLINA

Ever Disciplined

LastModifiedDate

09/20/2006