JASON C ALLEN DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016005189

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

ALLEN

Suffix

DPM

Business Name

JASON C ALLEN DPM

Original Issue Date

06/22/2004

Effective Date

02/01/2007

Expiration Date

01/31/2009

City

KINGMAN

State

Zip

86401

County

ARIZONA

Ever Disciplined

LastModifiedDate

03/17/2009