SAMUEL B TACKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068157

License Status

NOT RENEWED

Business

First Name

SAMUEL B

Last Name

TACKE

Suffix

Business Name

SAMUEL B TACKE MD

Original Issue Date

01/10/1984

Effective Date

01/10/1984

Expiration Date

07/31/1987

City

SKOKIE

State

Zip

60077

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006