SEAN PATRICK MACKENZIE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

SEAN

Middle

PATRICK

Last Name

MACKENZIE

Suffix

Business Name

SEAN PATRICK MACKENZIE MD

Original Issue Date

05/19/2004

Effective Date

07/11/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017