WESLEY KENNETH HAISTY JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041414

License Status

NOT RENEWED

Business

First Name

WESLEY KENNETH

Last Name

HAISTY JR

Suffix

Business Name

WESLEY KENNETH HAISTY JR MD

Original Issue Date

11/02/1967

Effective Date

11/02/1967

City

ROCKVILLE

State

Zip

20853

County

MARYLAND

Ever Disciplined

LastModifiedDate

09/20/2006