MATTHEW JUDSON MACCALLUM DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124769

License Status

NOT RENEWED

Business

First Name

MATTHEW

Middle

JUDSON

Last Name

MACCALLUM

Suffix

Business Name

MATTHEW JUDSON MACCALLUM DO

Original Issue Date

12/23/2009

Effective Date

12/23/2009

Expiration Date

07/31/2011

City

CHARLESTON

State

Zip

25314

County

WEST VIRGINIA

Ever Disciplined

LastModifiedDate

11/14/2011