MACKENZIE CAPSHAW ASEL - Medical Doctor License in Illinois | # 036145550

MACKENZIE CAPSHAW ASEL

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036145550

License Status

NOT RENEWED

Business

N

First Name

MACKENZIE

Middle

CAPSHAW

Last Name

ASEL

Business Name

MACKENZIE CAPSHAW ASEL

Original Issue Date

03/30/2018

Effective Date

03/30/2018

Expiration Date

09/30/2020

State

IL

Ever Disciplined

N

LastModifiedDate

01/14/2021