MARY CUSICK COLLINS - Medical Doctor License in Illinois | # 036059564

MARY CUSICK COLLINS

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059564

License Status

NOT RENEWED

Business

N

First Name

MARY

Middle

CUSICK

Last Name

COLLINS

Business Name

MARY CUSICK COLLINS

Original Issue Date

10/15/1979

Effective Date

05/01/2017

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021