BLACKMON, MICAH SHAWN
Medical - Resident Physician
Georgia 000169 Lapsed
This Georgia license was held by BLACKMON, MICAH SHAWN. The license is no longer active. It was granted on 07/02/2004 and expired on 06/30/2007
LICENSE DETAILS
- License Number: 000169
- Category: Resident Physician
- Status: Lapsed
- Date Granted: 07/02/2004 (almost 21 years ago)
- Expiry Date: 06/30/2007 (almost 18 years ago)
LOCATIONS
A Address
120 MAPLE HILL DR., Newnan 30265