MARK JAY MCGILLEM MD - Medical Doctor License in Indiana | # 036127983

MARK JAY MCGILLEM MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127983

License Status

NOT RENEWED

Business

N

First Name

MARK

Middle

JAY

Last Name

MCGILLEM

Suffix

MD

Business Name

MARK JAY MCGILLEM MD

Original Issue Date

06/01/2011

Effective Date

06/01/2011

Expiration Date

07/31/2014

State

IN

Ever Disciplined

N

LastModifiedDate

11/17/2014