DANIEL THEODORE LIS JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036123897

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

THEODORE

Last Name

LIS JR

Suffix

Business Name

DANIEL THEODORE LIS JR MD

Original Issue Date

07/06/2009

Effective Date

04/26/2011

Expiration Date

07/31/2014

City

FARMINGTON HILLS

State

Zip

48331

County

MICHIGAN

Ever Disciplined

LastModifiedDate

11/17/2014