MAURITS JAN WIERSEMA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000169

License Status

EXPIRED

Business

First Name

MAURITS

Middle

JAN

Last Name

WIERSEMA

Suffix

Business Name

MAURITS JAN WIERSEMA MD

Original Issue Date

09/10/2002

Effective Date

09/10/2002

Expiration Date

05/25/2003

City

POWELL

State

Zip

43065

Ever Disciplined

LastModifiedDate

09/23/2006