MARY ANNE A TABLIZO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095523

License Status

NOT RENEWED

Business

First Name

MARY ANNE A

Last Name

TABLIZO

Suffix

Business Name

MARY ANNE A TABLIZO MD

Original Issue Date

05/28/1997

Effective Date

05/28/1997

Expiration Date

07/31/1999

City

SUMMIT

State

Zip

07901

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

09/20/2006