MARK S RIDLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067465

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

RIDLEN

Suffix

Business Name

MARK S RIDLEN MD

Original Issue Date

08/31/1983

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

PROVIDENCE

State

Zip

02903

County

RHODE ISLAND

Ever Disciplined

LastModifiedDate

11/01/2017