LISA A COLLAZZO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036152734

License Status

NOT RENEWED

Business

Title

First Name

LISA

Middle

Last Name

COLLAZZO

Business Name

LISA A COLLAZZO MD

Original Issue Date

04/28/2020

Effective Date

04/28/2020

Expiration Date

07/31/2023

City

MEDIA

State

Zip

19063

Ever Disciplined

LastModifiedDate

11/30/2023