MARK WEIDENBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

MARK

Last Name

WEIDENBAUM

Suffix

Business Name

MARK WEIDENBAUM MD

Original Issue Date

07/28/1986

Effective Date

07/28/1986

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006