EVERETT DONALD MCKISSIC MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

CANCELLED

Business

First Name

EVERETT DONALD

Last Name

MCKISSIC

Suffix

Business Name

EVERETT DONALD MCKISSIC MD

Original Issue Date

09/14/1990

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SKOKIE

State

Zip

60076

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

04/07/2011