ROBERT BENJAMIN MACNACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

ACTIVE

Business

Title

First Name

ROBERT

Middle

BENJAMIN

Last Name

MACNACK

Business Name

ROBERT BENJAMIN MACNACK MD

Original Issue Date

07/13/2018

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

FREEPORT

State

Zip

61032

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023