LISA J SHIVES Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107292

License Status

ACTIVE

Business

First Name

LISA

Middle

Last Name

SHIVES

Business Name

LISA J SHIVES

Original Issue Date

06/28/2002

Effective Date

07/29/2023

Expiration Date

07/31/2026

City

SAN DIEGO

State

Zip

92103

County

COOK

Ever Disciplined

LastModifiedDate

07/29/2023