ANNA GENNADYEVNA MACKIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

NOT RENEWED

Business

Title

First Name

ANNA

Middle

GENNADYEVNA

Last Name

MACKIN

Business Name

ANNA GENNADYEVNA MACKIN MD

Original Issue Date

08/31/2019

Effective Date

05/06/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023