ALYSSA SELF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153620

License Status

NOT RENEWED

Business

Title

First Name

ALYSSA

Last Name

SELF

Business Name

ALYSSA SELF MD

Original Issue Date

07/08/2020

Effective Date

07/08/2020

Expiration Date

07/31/2023

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

11/30/2023