MARK A WILLARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104477

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

WILLARD

Suffix

Business Name

MARK A WILLARD MD

Original Issue Date

04/09/2001

Effective Date

04/09/2001

Expiration Date

07/31/2002

City

EVANSTON

State

Zip

60201

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006