MACKENZIE MATTERN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074113

License Status

EXPIRED

Business

Title

First Name

MACKENZIE

Last Name

MATTERN

Business Name

MACKENZIE MATTERN MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022