EDWARD P STACK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026443

License Status

EXPIRED

Business

First Name

EDWARD

Middle

Last Name

STACK

Business Name

EDWARD P STACK

Original Issue Date

05/06/1991

Effective Date

05/06/1991

Expiration Date

06/30/1992

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Family Practice & OMT

Ever Disciplined

LastModifiedDate

09/22/2006