DAVID LESLIE ZISOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056292

License Status

NOT RENEWED

Business

First Name

DAVID LESLIE

Last Name

ZISOW

Suffix

Business Name

DAVID LESLIE ZISOW MD

Original Issue Date

01/13/1978

Effective Date

01/13/1978

City

RANTOUL

State

Zip

61866

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/20/2006