MARK DAVID BERKSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

CANCELLED

Business

First Name

MARK

Middle

DAVID

Last Name

BERKSON

Suffix

Business Name

MARK DAVID BERKSON MD

Original Issue Date

10/25/2002

Effective Date

10/25/2002

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006