Name
License InformationLicense Information
| License Type | License Number | Expiration Date | Granted Date | License Name | License Status | | Licensure Actions or Pending Charges |
| Physician/Surgeon | 43367 | 05/31/2025 | 05/02/2005 | Jennifer Leach Gaudiani | INACTIVE | LAPSED DUE TO NON-RENEWAL | None |
|