MARK E TRACY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

MARK

Middle

Last Name

TRACY

Business Name

MARK E TRACY

Original Issue Date

06/17/2004

Effective Date

05/06/2011

Expiration Date

07/31/2014

City

EVERGREEN PARK

State

Zip

60805

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014