LISA R MACK Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036098668

License Status

INACTIVE

Business

First Name

LISA

Middle

Last Name

MACK

Business Name

LISA R MACK

Original Issue Date

08/13/1998

Effective Date

08/13/1998

Expiration Date

07/31/1999

City

HANOVER PARK

State

Zip

60103

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006