LORETTA JANE SCISM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036117901

License Status

NOT RENEWED

Business

First Name

LORETTA

Middle

JANE

Last Name

SCISM

Suffix

Business Name

LORETTA JANE SCISM MD

Original Issue Date

03/26/2007

Effective Date

03/26/2007

Expiration Date

07/31/2008

City

LOGAN

State

Zip

43138

County

KANE

Ever Disciplined

LastModifiedDate

11/06/2008