MARK KEVIN KIRKWOOD DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

MARK

Middle

KEVIN

Last Name

KIRKWOOD

Suffix

Business Name

MARK KEVIN KIRKWOOD DO

Original Issue Date

08/04/2016

Effective Date

07/17/2017

Expiration Date

09/30/2020

City

BLUE ISLAND

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021