MARY CUSICK COLLINS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036059564

License Status

NOT RENEWED

Business

First Name

MARY

Middle

CUSICK

Last Name

COLLINS

Business Name

MARY CUSICK COLLINS

Original Issue Date

10/15/1979

Effective Date

05/01/2017

Expiration Date

09/30/2020

City

HINES

State

Zip

60141

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021