LAKE SHORE OB/GYN OF DECATUR SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042618143

License Status

NOT RENEWED

Business

Business Name

LAKE SHORE OB/GYN OF DECATUR SC

Original Issue Date

12/29/2003

Effective Date

02/25/2020

Expiration Date

01/01/2022

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

03/24/2026