BRYAN MATTHEW LAZZARA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036127350

License Status

NOT RENEWED

Business

First Name

BRYAN

Middle

MATTHEW

Last Name

LAZZARA

Business Name

BRYAN MATTHEW LAZZARA

Original Issue Date

03/16/2011

Effective Date

06/01/2011

Expiration Date

07/31/2014

City

NEW YORK

State

Zip

10023

Ever Disciplined

LastModifiedDate

11/17/2014