PAUL RYAN VANTINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

Title

First Name

PAUL

Middle

RYAN

Last Name

VANTINE

Business Name

PAUL RYAN VANTINE MD

Original Issue Date

03/16/2015

Effective Date

03/16/2015

Expiration Date

07/31/2017

City

ALBUQUERQUE

State

Zip

87110

County

NEW MEXICO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017