| | Physician Last Name: | Rosen |
| | Physician First Name: | Jeffrey |
| | Physician Middle Name: | David |
| | Address: | 14 Rutland Plaza
#262
Rutland, VT 05701 |
| | License Number: | 123819 |
| | License Type: | MD |
| | Year of Birth: |
1947
|
| | Effective Date: | 04/06/2012 |
| | Action Description for DOH Webpage: | License surrender |
| | Misconduct Description for DOH Webpage: | The physician did not contest the charge of having his application for licensure denied by the Vermont State Board of Medical Practice for providing incorrect information when applying for licensure. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
