MARK MILLER SHULDBERG DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000456

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

MILLER

Last Name

SHULDBERG

Business Name

MARK MILLER SHULDBERG DO

Original Issue Date

10/25/2013

Effective Date

10/25/2013

Expiration Date

04/24/2014

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

08/12/2014