SEAN PATRICK MACKENZIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111320

License Status

NOT RENEWED

Business

First Name

SEAN

Middle

PATRICK

Last Name

MACKENZIE

Suffix

Business Name

SEAN PATRICK MACKENZIE MD

Original Issue Date

05/19/2004

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017