MARK R GARDNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

First Name

MARK R

Last Name

GARDNER

Suffix

Business Name

MARK R GARDNER MD

Original Issue Date

08/31/1987

Effective Date

08/31/1987

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020