FRED RICHARD STARK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036039352

License Status

NOT RENEWED

Business

First Name

FRED

Middle

RICHARD

Last Name

STARK

Business Name

FRED RICHARD STARK

Original Issue Date

12/09/2002

Effective Date

12/09/2002

Expiration Date

07/31/1965

City

ONTARIO

State

Zip

97914

County

OREGON

Ever Disciplined

LastModifiedDate

09/20/2006