JOSEPH MICHAEL MACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119076

License Status

NOT RENEWED

Business

First Name

JOSEPH

Middle

MICHAEL

Last Name

MACK

Suffix

Business Name

JOSEPH MICHAEL MACK MD

Original Issue Date

07/26/2007

Effective Date

06/04/2014

Expiration Date

07/31/2017

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

10/07/2024