LARRY VANGENDEREN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042200

License Status

NOT RENEWED

Business

First Name

LARRY

Last Name

VANGENDEREN

Suffix

Business Name

LARRY VANGENDEREN MD

Original Issue Date

10/23/1968

Effective Date

10/23/1968

City

JACKSON

State

Zip

83001

County

WYOMING

Ever Disciplined

LastModifiedDate

09/20/2006