MARK EDWARD MULLENDORE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036057331

License Status

NOT RENEWED

Business

First Name

MARK EDWARD

Last Name

MULLENDORE

Suffix

Business Name

MARK EDWARD MULLENDORE MD

Original Issue Date

08/10/1978

Effective Date

07/22/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/02/2021

Case Number

2017008846

Action

Suspension

Discipline Start Date

11/07/2019

Discipline End Date

06/27/2021

Discipline Reason

for failure to respond to the Department's request for information within thirty days.