MARK J STOUT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

MARK J

Last Name

STOUT

Suffix

Business Name

MARK J STOUT MD

Original Issue Date

08/29/1990

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014