ADAM LAWRENCE ZACK DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125078387

License Status

CANCELLED

Business

Title

First Name

ADAM

Middle

LAWRENCE

Last Name

ZACK

Business Name

ADAM LAWRENCE ZACK DO

Original Issue Date

06/24/2021

Effective Date

06/24/2021

Expiration Date

06/23/2024

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/30/2021