MARK EDWARD JACK HAUPT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

MARK EDWARD

Middle

JACK

Last Name

HAUPT

Suffix

Business Name

MARK EDWARD JACK HAUPT MD

Original Issue Date

06/09/2009

Effective Date

06/09/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020