MARK W MEWISSEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

CANCELLED

Business

First Name

MARK

Middle

Last Name

MEWISSEN

Suffix

Business Name

MARK W MEWISSEN MD

Original Issue Date

08/17/2000

Effective Date

08/17/2000

Expiration Date

07/31/2002

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006