JASON NATHANIEL MACKLIS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

ACTIVE

Business

Title

First Name

JASON

Middle

NATHANIEL

Last Name

MACKLIS

Business Name

JASON NATHANIEL MACKLIS MD

Original Issue Date

07/02/2013

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023