MARK L BACKUS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020747

License Status

EXPIRED

Business

First Name

MARK L

Last Name

BACKUS

Suffix

Business Name

MARK L BACKUS MD

Original Issue Date

05/08/1987

Effective Date

05/08/1987

Expiration Date

06/25/1990

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006