ROBERT G SLACK MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079585

License Status

INACTIVE

Business

First Name

ROBERT G

Last Name

SLACK

Suffix

Business Name

ROBERT G SLACK MD

Original Issue Date

11/28/1989

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHERRY VALLEY

State

Zip

61016

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

04/17/2008