MICHAEL DEAN MACK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139461

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

DEAN

Last Name

MACK

Suffix

Business Name

MICHAEL DEAN MACK DO

Original Issue Date

12/08/2015

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

WALCOTT

State

Zip

52773

County

FLORIDA

Ever Disciplined

LastModifiedDate

04/06/2023