MARK A VAN ANTWERP MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036080244

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

VAN ANTWERP

Suffix

Business Name

MARK A VAN ANTWERP MD

Original Issue Date

07/02/1990

Effective Date

07/02/1990

Expiration Date

07/31/1993

City

COUDERDERSPORT

State

Zip

16915

County

PENNSYLVANIA

Ever Disciplined

LastModifiedDate

02/03/2007

Case Number

2004001246

Action

Refuse To Renew

Discipline Start Date

04/21/2004

Discipline Reason

Disciplined in Arizona.