CHARLES MARTIN SLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048353

License Status

ACTIVE

Business

First Name

CHARLES MARTIN

Last Name

SLACK

Suffix

Business Name

CHARLES MARTIN SLACK MD

Original Issue Date

09/19/1973

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2023