PHILLIP CLAUDE HISTAND MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055008

License Status

INACTIVE

Business

First Name

PHILLIP CLAUDE

Last Name

HISTAND

Suffix

Business Name

PHILLIP CLAUDE HISTAND MD

Original Issue Date

07/18/1977

Effective Date

07/18/1977

Expiration Date

07/31/1990

City

CORVALLIS

State

Zip

97331

County

OREGON

Ever Disciplined

LastModifiedDate

09/20/2006