MARK W DERSCH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125023468

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

DERSCH

Business Name

MARK W DERSCH

Original Issue Date

05/02/1989

Effective Date

05/02/1989

Expiration Date

06/30/1994

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006