MICHAEL D MASTAKAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

MASTAKAS

Suffix

Business Name

MICHAEL D MASTAKAS MD

Original Issue Date

09/03/1981

Effective Date

06/16/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011