JACK LANCELOT LICHTOR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062481

License Status

NOT RENEWED

Business

First Name

JACK LANCELOT

Last Name

LICHTOR

Suffix

Business Name

JACK LANCELOT LICHTOR MD

Original Issue Date

07/10/1981

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

BEAVERTON

State

Zip

97006

County

OREGON

Ever Disciplined

LastModifiedDate

11/17/2014