AMY KATHLEEN LICIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036154832

License Status

ACTIVE

Business

Title

First Name

AMY

Middle

KATHLEEN

Last Name

LICIS

Business Name

AMY KATHLEEN LICIS MD

Original Issue Date

11/21/2020

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

WEBSTER GROVES

State

Zip

63119

Ever Disciplined

LastModifiedDate

07/22/2023