MARK STEPHEN WOOD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

MARK

Middle

STEPHEN

Last Name

WOOD

Business Name

MARK STEPHEN WOOD MD

Original Issue Date

11/01/2011

Effective Date

05/01/2014

Expiration Date

07/31/2017

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017