NELLY K MAC MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056214

License Status

NOT RENEWED

Business

First Name

NELLY K

Last Name

MAC

Suffix

Business Name

NELLY K MAC MD

Original Issue Date

12/16/1977

Effective Date

12/16/1977

Expiration Date

07/31/1984

City

VENTURA

State

Zip

93006

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006