TEDD W GENTRY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076582

License Status

INACTIVE

Business

First Name

TEDD W

Last Name

GENTRY

Suffix

Business Name

TEDD W GENTRY MD

Original Issue Date

01/13/1988

Effective Date

01/13/1988

Expiration Date

07/31/1990

City

BLACK RIVER FALLS

State

Zip

54615

County

WISCONSIN

Ever Disciplined

LastModifiedDate

09/20/2006