BETH MARA MARSHALL-BERGMAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060012

License Status

CANCELLED

Business

Title

First Name

BETH

Middle

MARA

Last Name

MARSHALL-BERGMAN

Business Name

BETH MARA MARSHALL-BERGMAN DO

Original Issue Date

06/24/2011

Effective Date

06/24/2011

Expiration Date

06/23/2014

City

BOSTON

State

Zip

02111

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014