HEATHER NELL GILLUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109368

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

NELL

Last Name

GILLUM

Suffix

Business Name

HEATHER NELL GILLUM MD

Original Issue Date

06/09/2003

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

AMHERST

State

Zip

03031

Ever Disciplined

LastModifiedDate

11/06/2008