J MARK KIRK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

First Name

J MARK

Last Name

KIRK

Suffix

Business Name

J MARK KIRK DO

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

FORT SHERIDAN

State

Zip

60037

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011