SUSAN R WIERSMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036090395

License Status

NOT RENEWED

Business

First Name

SUSAN R

Last Name

WIERSMA

Suffix

Business Name

SUSAN R WIERSMA MD

Original Issue Date

03/25/1995

Effective Date

03/25/1995

Expiration Date

07/31/1999

City

MADISON

State

Zip

53711

County

WISCONSIN

Ever Disciplined

LastModifiedDate

08/08/2014