VIVIAN F TOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036148728

License Status

NOT RENEWED

Business

Title

First Name

VIVIAN

Middle

Last Name

TOM

Business Name

VIVIAN F TOM MD

Original Issue Date

03/22/2019

Effective Date

03/22/2019

Expiration Date

09/30/2020

City

MOUNT KISCO

State

Zip

10549

County

NEW YORK

Ever Disciplined

LastModifiedDate

01/14/2021