RICHARD D DAVENPORT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036044999

License Status

INACTIVE

Business

First Name

RICHARD D

Last Name

DAVENPORT

Suffix

Business Name

RICHARD D DAVENPORT MD

Original Issue Date

11/24/1971

Effective Date

11/24/1971

Expiration Date

07/31/1987

City

WEST ALLIS

State

Zip

53227

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006