KEITH MANKOWITZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

NOT RENEWED

Business

First Name

KEITH

Last Name

MANKOWITZ

Suffix

Business Name

KEITH MANKOWITZ MD

Original Issue Date

07/11/2008

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014