MARY N TILAK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104323

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

TILAK

Business Name

MARY N TILAK

Original Issue Date

03/07/2001

Effective Date

03/07/2001

Expiration Date

07/31/2005

City

HIGHLAND

State

Zip

46322

County

INDIANA

Ever Disciplined

LastModifiedDate

10/09/2006