MARK M TANAKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105763

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

TANAKA

Suffix

Business Name

MARK M TANAKA MD

Original Issue Date

10/24/2001

Effective Date

10/24/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60660

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006