TAMARA LEE LYDAY DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

Title

First Name

TAMARA

Middle

LEE

Last Name

LYDAY

Business Name

TAMARA LEE LYDAY DO

Original Issue Date

08/06/2008

Effective Date

08/06/2008

Expiration Date

07/31/2011

City

GREEN BAY

State

Zip

54304

County

BROWN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/01/2020