The holder whose full name is BERKOVITZ, KENNETH EUGENE,come from INDIANAPOLIS IN,hold the Physician license(NO.01036766A) which status is Expired Non-Renewable.
Name | BERKOVITZ, KENNETH EUGENE |
---|---|
License Number | 01036766A |
License Type | Physician |
License Status | Expired Non-Renewable |
City | INDIANAPOLIS |
State | IN |