GEOFFREY A WISS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109106

License Status

NOT RENEWED

Business

First Name

GEOFFREY

Middle

Last Name

WISS

Suffix

Business Name

GEOFFREY A WISS MD

Original Issue Date

04/28/2003

Effective Date

04/28/2003

Expiration Date

07/31/2005

City

SOUTHFIELD

State

Zip

48034

County

MICHIGAN

Ever Disciplined

LastModifiedDate

10/09/2006