MICHAEL STEPHEN GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048505

License Status

NOT RENEWED

Business

First Name

MICHAEL STEPHEN

Last Name

GREEN

Suffix

Business Name

MICHAEL STEPHEN GREEN MD

Original Issue Date

12/18/1973

Effective Date

12/18/1973

City

METROPOLIS

State

Zip

62960

County

MASSAC

Ever Disciplined

LastModifiedDate

09/20/2006