THOMAS A DIVEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

DIVEN

Suffix

Business Name

THOMAS A DIVEN MD

Original Issue Date

06/01/2011

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

HARLEYSVILLE

State

Zip

19438

County

PENNSYLVANIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014