MARK DANIEL COUSINEAU MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044277

License Status

EXPIRED

Business

First Name

MARK

Middle

DANIEL

Last Name

COUSINEAU

Suffix

Business Name

MARK DANIEL COUSINEAU MD

Original Issue Date

06/22/2002

Effective Date

06/22/2002

Expiration Date

06/23/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006