KEISCHA LORRAINE GLENN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036128110

License Status

NOT RENEWED

Business

First Name

KEISCHA

Middle

LORRAINE

Last Name

GLENN

Suffix

Business Name

KEISCHA LORRAINE GLENN DO

Original Issue Date

06/21/2011

Effective Date

06/21/2011

Expiration Date

07/31/2014

City

COLUMBIA

State

Zip

21044

County

MARYLAND

Ever Disciplined

LastModifiedDate

11/17/2014