MARK L DA COSTA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125038958

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

DA COSTA

Suffix

Business Name

MARK L DA COSTA MD

Original Issue Date

04/12/1999

Effective Date

04/12/1999

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Cardiothoracic Surgery

Ever Disciplined

LastModifiedDate

09/22/2006