BRANDON V MACK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044363

License Status

EXPIRED

Business

First Name

BRANDON

Middle

Last Name

MACK

Suffix

Business Name

BRANDON V MACK MD

Original Issue Date

05/06/2002

Effective Date

05/06/2002

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006