MAUREEN ALICE C MACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

MAUREEN ALICE C

Last Name

MACK

Suffix

Business Name

MAUREEN ALICE C MACK MD

Original Issue Date

01/01/1997

Expiration Date

01/01/1997

City

CHATHAM

State

Zip

62629

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006