MARK KONWISER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

KONWISER

Suffix

Business Name

MARK KONWISER MD

Original Issue Date

12/23/1982

Effective Date

12/23/1982

Expiration Date

07/31/1987

City

ST LOUIS

State

Zip

63121

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006