MARK T BAMMAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

MARK

Middle

Last Name

BAMMAN

Suffix

Business Name

MARK T BAMMAN MD

Original Issue Date

04/04/2017

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

NEW LENOX

State

Zip

60451

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/14/2023