KIM C NUSSBAUM Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109807

License Status

NOT RENEWED

Business

First Name

KIM

Middle

Last Name

NUSSBAUM

Business Name

KIM C NUSSBAUM

Original Issue Date

07/30/2003

Effective Date

05/19/2011

Expiration Date

07/31/2014

City

FOUNTAIN HILLS

State

Zip

85268

County

ARIZONA

Ever Disciplined

LastModifiedDate

11/17/2014