MARK J COLLINS 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 J

Last Name

COLLINS

Business Name

MARK J COLLINS

Original Issue Date

08/01/1991

Effective Date

08/01/1991

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006