MARK D GIDEONSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

MARK D

Last Name

GIDEONSEN

Business Name

MARK D GIDEONSEN

Original Issue Date

07/29/1997

Effective Date

07/29/1997

Expiration Date

07/31/2002

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006