MARK GREGORY LEWIS DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069128

License Status

INACTIVE

Business

First Name

MARK GREGORY

Last Name

LEWIS

Suffix

Business Name

MARK GREGORY LEWIS DO

Original Issue Date

08/03/1984

Effective Date

08/03/1984

Expiration Date

07/31/1990

City

SOUTH BEND

State

Zip

46615

County

INDIANA

Ever Disciplined

LastModifiedDate

08/17/2012