TENNISON LEWIS MALCOLM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155833

License Status

ACTIVE

Business

Title

First Name

TENNISON

Middle

LEWIS

Last Name

MALCOLM

Business Name

TENNISON LEWIS MALCOLM MD

Original Issue Date

03/01/2021

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

BOSTON

State

Zip

02114

Ever Disciplined

LastModifiedDate

02/14/2025