LELAND J FROM MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036076071

License Status

INACTIVE

Business

First Name

LELAND J

Last Name

FROM

Suffix

Business Name

LELAND J FROM MD

Original Issue Date

10/02/1987

Effective Date

04/08/2016

Expiration Date

07/31/2017

City

BELOIT

State

Zip

53511

County

WISCONSIN

Ever Disciplined

LastModifiedDate

04/12/2017