ETHEL SUSAN HERSKOVIC DO - Medical Doctor License in Minnesota | # 125053522

ETHEL SUSAN HERSKOVIC DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053522

License Status

CANCELLED

Business

N

Title

DO

First Name

ETHEL

Middle

SUSAN

Last Name

HERSKOVIC

Business Name

ETHEL SUSAN HERSKOVIC DO

Original Issue Date

08/18/2010

Effective Date

08/18/2010

Expiration Date

08/17/2012

State

MN

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

N

LastModifiedDate

08/10/2010