LISA ELLEN PACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127401

License Status

ACTIVE

Business

First Name

LISA

Middle

ELLEN

Last Name

PACK

Suffix

Business Name

LISA ELLEN PACK MD

Original Issue Date

03/25/2011

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

MONKTON

State

Zip

21111

Ever Disciplined

LastModifiedDate

04/11/2023