NELLY K MAC MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

CANCELLED

Business

First Name

NELLY K

Last Name

MAC

Suffix

Business Name

NELLY K MAC MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

VENTURA

State

Zip

93003

County

CALIFORNIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006