MARK L BARBA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

First Name

MARK L

Last Name

BARBA

Suffix

Business Name

MARK L BARBA MD

Original Issue Date

10/11/1996

Effective Date

04/24/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020