LISA A MIMS Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096055

License Status

INACTIVE

Business

First Name

LISA A

Last Name

MIMS

Business Name

LISA A MIMS

Original Issue Date

07/17/1997

Effective Date

06/23/2011

Expiration Date

07/31/2014

City

AVON

State

Zip

46123

County

INDIANA

Ever Disciplined

LastModifiedDate

04/08/2014