MARK NORMAN GOODMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

MARK

Middle

NORMAN

Last Name

GOODMAN

Suffix

Business Name

MARK NORMAN GOODMAN MD

Original Issue Date

08/22/2005

Effective Date

08/22/2005

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008