ALISHA MICHELLE MAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

Title

First Name

ALISHA

Middle

MICHELLE

Last Name

MAVIS

Business Name

ALISHA MICHELLE MAVIS MD

Original Issue Date

08/07/2014

Effective Date

08/07/2014

Expiration Date

07/31/2017

City

MENOMONEE FALLS

State

Zip

53051

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017