JAY L LISS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036046772

License Status

INACTIVE

Business

First Name

JAY L

Last Name

LISS

Suffix

Business Name

JAY L LISS MD

Original Issue Date

01/23/1973

Effective Date

01/23/1973

Expiration Date

07/31/2005

City

CHESTER

State

Zip

62233

County

RANDOLPH

Ever Disciplined

LastModifiedDate

10/09/2006