MARTA M SHUSHUNOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036066683

License Status

NOT RENEWED

Business

First Name

MARTA M

Last Name

SHUSHUNOV

Suffix

Business Name

MARTA M SHUSHUNOV MD

Original Issue Date

06/14/1983

Effective Date

06/14/1983

Expiration Date

07/31/1993

City

MACKINAW

State

Zip

61755

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/20/2006