BRYAN MATTHEW LAZZARA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

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

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014