KIRK MAURICE CHAN-TACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105436

License Status

NOT RENEWED

Business

First Name

KIRK

Middle

MAURICE

Last Name

CHAN-TACK

Suffix

Business Name

KIRK MAURICE CHAN-TACK MD

Original Issue Date

08/17/2001

Effective Date

08/17/2001

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006