MARK W PENN MD 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

PENN

Suffix

Business Name

MARK W PENN MD

Original Issue Date

11/18/2009

Effective Date

11/18/2009

Expiration Date

07/31/2011

City

WAUCONDA

State

Zip

60084

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011