Licensee: Keith Bangart
License Number:
POD-000724
License Issued:
03/16/2020
License Cancellation:
03/16/2020
License Status:
Active
Discipline Action:
Yes
Phone:
4803115150
Address:
1986 W Russell Dr ave
Gilbert
AZ
85212
Discipline Summary
Complaint Number:
19-32-C
License Status:
Active
Discipline Notes:
Non-Disciplinary Order for Continuing Medical Education
