CARL SCOTT TACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

Title

First Name

CARL

Middle

SCOTT

Last Name

TACK

Business Name

CARL SCOTT TACK MD

Original Issue Date

07/09/2020

Effective Date

11/26/2024

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/28/2025