MICHAEL THOMAS STACK MD - Medical Doctor License in Illinois | # 036158064

MICHAEL THOMAS STACK MD

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036158064

License Status

NOT RENEWED

Business

N

Title

MD

First Name

MICHAEL

Middle

THOMAS

Last Name

STACK

Business Name

MICHAEL THOMAS STACK MD

Original Issue Date

08/19/2021

Effective Date

08/19/2021

Expiration Date

07/31/2023

State

IL

Ever Disciplined

N

LastModifiedDate

11/30/2023