KEITH D TATKA DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052742

License Status

CANCELLED

Business

Title

First Name

KEITH

Middle

Last Name

TATKA

Business Name

KEITH D TATKA DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2010

City

RALEIGH

State

Zip

27612

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/05/2008