MARK WADE NIELSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115004

License Status

NOT RENEWED

Business

First Name

MARK

Middle

WADE

Last Name

NIELSEN

Suffix

Business Name

MARK WADE NIELSEN MD

Original Issue Date

12/16/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SIOUX CITY

State

Zip

51106

County

IOWA

Ever Disciplined

LastModifiedDate

11/14/2011