JOHN IVAN BLAIR ANTONIUS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036087897

License Status

INACTIVE

Business

First Name

JOHN IVAN BLAIR

Last Name

ANTONIUS

Suffix

Business Name

JOHN IVAN BLAIR ANTONIUS MD

Original Issue Date

12/31/1993

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CANBY

State

Zip

97013

Ever Disciplined

LastModifiedDate

06/23/2008