JACK M BERT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158909

License Status

NOT RENEWED

Business

Title

First Name

JACK

Middle

Last Name

BERT

Business Name

JACK M BERT MD

Original Issue Date

12/03/2021

Effective Date

12/03/2021

Expiration Date

07/31/2023

City

WOODBURY

State

Zip

55129

County

WASHINGTON

Ever Disciplined

LastModifiedDate

11/30/2023