MARK THOMAS COLLINS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034072

License Status

EXPIRED

Business

First Name

MARK

Middle

THOMAS

Last Name

COLLINS

Suffix

Business Name

MARK THOMAS COLLINS MD

Original Issue Date

05/02/1996

Effective Date

05/02/1996

Expiration Date

06/22/1997

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006