LISA RENEE EMM Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115642

License Status

ACTIVE

Business

First Name

LISA

Middle

RENEE

Last Name

EMM

Business Name

LISA RENEE EMM

Original Issue Date

04/06/2006

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

04/13/2023