LARA LEA PHILLIPS MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140545

License Status

INACTIVE

Business

Title

First Name

LARA

Middle

LEA

Last Name

PHILLIPS

Business Name

LARA LEA PHILLIPS MD

Original Issue Date

05/03/2016

Effective Date

06/27/2017

Expiration Date

09/30/2020

City

PHILADELPHIA

State

Zip

19107

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

04/05/2020