JERRY MICHAEL SPECKMAN MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099336

License Status

INACTIVE

Business

First Name

JERRY

Middle

MICHAEL

Last Name

SPECKMAN

Suffix

Business Name

JERRY MICHAEL SPECKMAN MD

Original Issue Date

12/02/1998

Effective Date

12/02/1998

Expiration Date

07/31/2002

City

SALT LAKE CITY

State

Zip

84132

County

UTAH

Ever Disciplined

LastModifiedDate

10/09/2006