MARK EDWARD JACK HAUPT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050748

License Status

CANCELLED

Business

First Name

MARK EDWARD

Middle

JACK

Last Name

HAUPT

Suffix

Business Name

MARK EDWARD JACK HAUPT MD

Original Issue Date

06/24/2006

Effective Date

06/24/2006

Expiration Date

06/23/2009

City

WINNATKE

State

Zip

60093

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006