MARK J GODDARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036069668

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

GODDARD

Suffix

Business Name

MARK J GODDARD MD

Original Issue Date

10/17/1984

Effective Date

10/17/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60645

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006