LIZA ANTOINETTE JAIN PHU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129032

License Status

NOT RENEWED

Business

Title

First Name

LIZA ANTOINETTE

Middle

JAIN

Last Name

PHU

Business Name

LIZA ANTOINETTE JAIN PHU MD

Original Issue Date

09/27/2011

Effective Date

04/14/2014

Expiration Date

07/31/2017

City

DECATUR

State

Zip

62521

County

MACON

Ever Disciplined

LastModifiedDate

11/01/2017