SCOTT W MACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036068997

License Status

NOT RENEWED

Business

First Name

SCOTT W

Last Name

MACK

Suffix

Business Name

SCOTT W MACK MD

Original Issue Date

07/12/1984

Effective Date

07/12/1984

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60638

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006