KENNETH RIDGE MACEK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046097

License Status

CANCELLED

Business

First Name

KENNETH

Middle

RIDGE

Last Name

MACEK

Suffix

Business Name

KENNETH RIDGE MACEK MD

Original Issue Date

06/24/2003

Effective Date

06/24/2003

Expiration Date

06/23/2007

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006