WALLACE PATRICK BERKOWITZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

WALLACE

Middle

PATRICK

Last Name

BERKOWITZ

Suffix

Business Name

WALLACE PATRICK BERKOWITZ MD

Original Issue Date

01/01/1997

Effective Date

06/05/2014

Expiration Date

07/31/2017

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017