License holder summary

Mary Anne Quiambao Eisma is a Medical Board - 58.Do Training Certificate licensed to practice in Ohio. The address on file for Mary Anne Quiambao Eisma is Wright State University, c/o Internal Medicine Dept, 128 E Apple Street CHE-2nd Floor, Dayton, OH 45409. This licensed professional license is not current. The license was granted 10/14/2010 and expired on 06/30/2013.

Ohio

Board of Licensing

Mary Anne Quiambao Eisma
Medical Board - 58.Do Training Certificate
License number
58.003697
Date granted
10/14/2010
Date expires
06/30/2013
Class
Medical Board - 58.Do Training Certificate
Status
Failed to Renew
Address
Wright State University, c/o Internal Medicine Dept, 128 E Apple Street CHE-2nd Floor, Dayton, OH 45409
ohiolicensing.org
ID 29383092
LAST UPDATED 2024-04-24 11:33:53 UTC

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