MARK J CORSALE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

CORSALE

Business Name

MARK J CORSALE

Original Issue Date

10/30/1981

Effective Date

10/30/1981

Expiration Date

07/31/1987

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006