MARK PAUL BOGNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

First Name

MARK PAUL

Last Name

BOGNER

Suffix

Business Name

MARK PAUL BOGNER MD

Original Issue Date

11/12/1996

Effective Date

11/12/1996

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006