ELYSSE TOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155884

License Status

NOT RENEWED

Business

Title

First Name

ELYSSE

Last Name

TOM

Business Name

ELYSSE TOM MD

Original Issue Date

03/04/2021

Effective Date

03/04/2021

Expiration Date

07/31/2023

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Ever Disciplined

LastModifiedDate

11/30/2023