ALAN WIESE ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036035666

License Status

NOT RENEWED

Business

First Name

ALAN WIESE

Last Name

ANDERSON

Suffix

Business Name

ALAN WIESE ANDERSON MD

Original Issue Date

03/04/1959

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

MT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/14/2011