MARK ALVIN KEROACK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104691

License Status

INACTIVE

Business

First Name

MARK

Middle

ALVIN

Last Name

KEROACK

Suffix

Business Name

MARK ALVIN KEROACK MD

Original Issue Date

05/14/2001

Effective Date

04/12/2011

Expiration Date

07/31/2014

City

WEST SPRINGFIELD

State

Zip

01089

Ever Disciplined

LastModifiedDate

07/21/2014