LORETTA JANE SCISM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047260

License Status

EXPIRED

Business

First Name

LORETTA

Middle

JANE

Last Name

SCISM

Suffix

Business Name

LORETTA JANE SCISM MD

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

QUINCY

State

Zip

62301

County

ADAMS

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/03/2007