MARTHA QUIST LACY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131280

License Status

NOT RENEWED

Business

Title

First Name

MARTHA

Middle

QUIST

Last Name

LACY

Business Name

MARTHA QUIST LACY MD

Original Issue Date

08/31/2012

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

ROCHESTER

State

Zip

55905

County

MINNESOTA

Ever Disciplined

LastModifiedDate

01/14/2021