WAYNE MARK KEISERMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

First Name

WAYNE MARK

Last Name

KEISERMAN

Suffix

Business Name

WAYNE MARK KEISERMAN MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1981

City

CANTON

State

Zip

61520

County

FULTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006