JACK MARK LEVINE DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

JACK

Middle

MARK

Last Name

LEVINE

Suffix

Business Name

JACK MARK LEVINE DO

Original Issue Date

01/11/2002

Effective Date

01/11/2002

Expiration Date

07/31/2008

City

SHELBYVILLE

State

Zip

62565

County

SHELBY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2010

Case Number

2007009774

Action

Suspension

Discipline Start Date

04/06/2010

Discipline Reason

after being disciplined by the state of Ohio.