CARISSA NICOLETTE KIRK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036162354

License Status

NOT RENEWED

Business

Title

First Name

CARISSA

Middle

NICOLETTE

Last Name

KIRK

Business Name

CARISSA NICOLETTE KIRK DO

Original Issue Date

09/13/2022

Effective Date

09/13/2022

Expiration Date

07/31/2023

City

MURPHYSBORO

State

Zip

62966

County

JACKSON

Ever Disciplined

LastModifiedDate

11/30/2023