MARK WILLIAM GREEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036095678

License Status

NOT RENEWED

Business

First Name

MARK WILLIAM

Last Name

GREEN

Business Name

MARK WILLIAM GREEN

Original Issue Date

06/20/1997

Effective Date

06/20/1997

Expiration Date

07/31/2002

City

MONTVALE

State

Zip

07645

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

10/09/2006