ELLIS, MARK BRIAN, DO
Medical - Physician
Georgia 042564 Lapsed
This Georgia license was held by ELLIS, MARK BRIAN, DO. The license is no longer active. It was granted on 10/03/1996 and expired on 09/30/2007
LICENSE DETAILS
- License Number: 042564
- Category: Physician
- Status: Lapsed
- Date Granted: 10/03/1996 (over 28 years ago)
- Expiry Date: 09/30/2007 (over 17 years ago)
LOCATIONS
A Address
557 GLOVER AVE | SUITE 27, ENTERPRISE 36330