MICHAEL DEAN MACK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

DEAN

Last Name

MACK

Suffix

Business Name

MICHAEL DEAN MACK DO

Original Issue Date

12/11/2015

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

WALCOTT

State

Zip

52773

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023