MARK THOMAS COLLINS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102502

License Status

NOT RENEWED

Business

First Name

MARK

Middle

THOMAS

Last Name

COLLINS

Suffix

Business Name

MARK THOMAS COLLINS MD

Original Issue Date

05/17/2000

Effective Date

05/17/2000

Expiration Date

07/31/2005

City

HARVARD

State

Zip

01451

Ever Disciplined

LastModifiedDate

10/09/2006