WALLACE PATRICK BERKOWITZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041982

License Status

NOT RENEWED

Business

First Name

WALLACE

Middle

PATRICK

Last Name

BERKOWITZ

Suffix

Business Name

WALLACE PATRICK BERKOWITZ MD

Original Issue Date

08/01/1968

Effective Date

06/05/2014

Expiration Date

07/31/2017

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

11/01/2017

Case Number

2014005655

Action

Permanent Inactive

Discipline Start Date

02/23/2015