NICHOLAS G LEZAMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120544

License Status

NOT RENEWED

Business

First Name

NICHOLAS

Middle

Last Name

LEZAMA

Suffix

Business Name

NICHOLAS G LEZAMA MD

Original Issue Date

04/11/2008

Effective Date

04/11/2008

Expiration Date

07/31/2011

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/14/2011