MARY L DISIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

MARY L

Last Name

DISIS

Suffix

Business Name

MARY L DISIS MD

Original Issue Date

08/17/1989

Effective Date

08/17/1989

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

09/26/2006