MARK ALLEN BRISSO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

MARK

Middle

ALLEN

Last Name

BRISSO

Suffix

Business Name

MARK ALLEN BRISSO MD

Original Issue Date

08/05/2003

Effective Date

08/05/2003

Expiration Date

07/31/2008

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008