MARK CHARLES MONTAG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102495

License Status

NOT RENEWED

Business

First Name

MARK

Middle

CHARLES

Last Name

MONTAG

Suffix

Business Name

MARK CHARLES MONTAG MD

Original Issue Date

05/16/2000

Effective Date

05/16/2000

Expiration Date

07/31/2002

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/09/2006