STEPHEN MICHAEL NIESEN
Medical Physician And Surgeon
Pennsylvania MD011600E Revoked
This Pennsylvania license was held by STEPHEN MICHAEL NIESEN. The license is no longer active. It was granted on 03/11/1970 and expired on 12/31/1982
LICENSE DETAILS
- License Number: MD011600E
- Category: Medical Physician and Surgeon
- Status: Revoked
- Date Granted: 03/11/1970 (about 54 years ago)
- Expiry Date: 12/31/1982 (over 41 years ago)
LOCATIONS
A Address
FAIRLAWN NJ 07410