MARK HOWARD HANSCOM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069191

License Status

EXPIRED

Business

Title

First Name

MARK

Middle

HOWARD

Last Name

HANSCOM

Business Name

MARK HOWARD HANSCOM MD

Original Issue Date

06/24/2016

Effective Date

06/24/2016

Expiration Date

06/23/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/02/2019