BLAINE M LISNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036065238

License Status

NOT RENEWED

Business

First Name

BLAINE M

Last Name

LISNER

Suffix

Business Name

BLAINE M LISNER MD

Original Issue Date

08/20/1982

Effective Date

07/12/2017

Expiration Date

09/30/2020

City

LOUISVILLE

State

Zip

40245

County

KENTUCKY

Ever Disciplined

LastModifiedDate

01/14/2021