MARK S DORFMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

DORFMAN

Suffix

Business Name

MARK S DORFMAN MD

Original Issue Date

07/16/1993

Effective Date

07/16/1993

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006