JOSHUA KAVIN MODDER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036116006

License Status

INACTIVE

Business

First Name

JOSHUA

Middle

KAVIN

Last Name

MODDER

Suffix

Business Name

JOSHUA KAVIN MODDER MD

Original Issue Date

05/23/2006

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

APPLETON

State

Zip

54911

Ever Disciplined

LastModifiedDate

04/17/2008