KYLE M ANNEN DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131265

License Status

INACTIVE

Business

Title

First Name

KYLE

Middle

Last Name

ANNEN

Business Name

KYLE M ANNEN DO

Original Issue Date

08/29/2012

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

RIDGEWOOD

State

Zip

11385

County

NEW YORK

Ever Disciplined

LastModifiedDate

04/11/2017