SALLY Q TAN Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091561

License Status

INACTIVE

Business

First Name

SALLY Q

Last Name

TAN

Business Name

SALLY Q TAN

Original Issue Date

08/14/1995

Effective Date

08/14/1995

Expiration Date

07/31/2005

City

EDMOND

State

Zip

73003

County

OKLAHOMA

Ever Disciplined

LastModifiedDate

10/09/2006