PAUL C TACK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

ACTIVE

Business

First Name

PAUL

Middle

Last Name

TACK

Business Name

PAUL C TACK

Original Issue Date

10/29/1998

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023