MARK DUANE GOODMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

MARK DUANE

Last Name

GOODMAN

Suffix

Business Name

MARK DUANE GOODMAN MD

Original Issue Date

10/22/1986

Effective Date

10/22/1986

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006