MARK E MASS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

MARK E

Last Name

MASS

Suffix

Business Name

MARK E MASS MD

Original Issue Date

07/10/1996

Effective Date

04/18/2014

Expiration Date

07/31/2017

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020