MARA DIVIS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129431

License Status

ACTIVE

Business

Title

First Name

MARA

Last Name

DIVIS

Business Name

MARA DIVIS DO

Original Issue Date

01/05/2012

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/16/2023