GERALD JOSEPH LIESEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036036008

License Status

NOT RENEWED

Business

First Name

GERALD JOSEPH

Last Name

LIESEN

Suffix

Business Name

GERALD JOSEPH LIESEN MD

Original Issue Date

08/31/1959

Effective Date

06/30/2014

Expiration Date

07/31/2017

City

GENEVA

State

Zip

60134

County

KANE

Ever Disciplined

LastModifiedDate

11/01/2017