THEODORE RAYMOND MATHENY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102888

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

RAYMOND

Last Name

MATHENY

Suffix

Business Name

THEODORE RAYMOND MATHENY MD

Original Issue Date

06/28/2000

Effective Date

06/28/2000

Expiration Date

07/31/2002

City

FORKS

State

Zip

98331

County

WASHINGTON

Ever Disciplined

LastModifiedDate

10/09/2006