ALICE-GRAY LEWIS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072035

License Status

CANCELLED

Business

Title

First Name

ALICE-GRAY

Last Name

LEWIS

Business Name

ALICE-GRAY LEWIS DO

Original Issue Date

06/25/2018

Effective Date

06/25/2018

Expiration Date

06/24/2021

City

SANTA ROSA

State

Zip

95403

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/18/2018