MARK S KERMGARD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

KERMGARD

Business Name

MARK S KERMGARD

Original Issue Date

09/25/1995

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

FOND DU LAC

State

Zip

54937

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021