DIANE M MACKIE DO Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077210

License Status

INACTIVE

Business

First Name

DIANE M

Last Name

MACKIE

Suffix

Business Name

DIANE M MACKIE DO

Original Issue Date

06/25/1988

Effective Date

06/25/1988

Expiration Date

07/31/1993

City

LAGRANGE

State

Zip

60525

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006