MATTHEW JAY WISE MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112805

License Status

INACTIVE

Business

First Name

MATTHEW

Middle

JAY

Last Name

WISE

Suffix

Business Name

MATTHEW JAY WISE MD

Original Issue Date

12/23/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

GALLUP

State

Zip

87301

Ever Disciplined

LastModifiedDate

07/03/2007

Case Number

2007002243

Action

Refuse To Renew

Discipline Start Date

06/05/2007

Discipline Reason

after being disciplined in the state of Florida.