BERKMAN O GORDON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

BERKMAN O

Last Name

GORDON

Business Name

BERKMAN O GORDON

Original Issue Date

05/13/2019

Effective Date

05/13/2019

Expiration Date

09/30/2020

City

ALEDO

State

Zip

61231

County

MERCER

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021