MARK STEPHEN TRAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114331

License Status

NOT RENEWED

Business

First Name

MARK

Middle

STEPHEN

Last Name

TRAVIS

Suffix

Business Name

MARK STEPHEN TRAVIS MD

Original Issue Date

08/03/2005

Effective Date

09/04/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

11/30/2023

Case Number

2021006473

Action

Suspension

Discipline Start Date

11/12/2021

Discipline Reason

Failure to file and/or pay Illinois state income taxes.