TODD M MACK DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

TODD

Middle

Last Name

MACK

Suffix

DPM

Business Name

TODD M MACK DPM

Original Issue Date

04/23/2010

Effective Date

04/23/2010

Expiration Date

01/31/2011

City

HUNTLEY

State

Zip

60142

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/10/2011