MARK KENNETH MAGNUS DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

Title

DPM

First Name

MARK

Middle

KENNETH

Last Name

MAGNUS

Business Name

MARK KENNETH MAGNUS DPM

Original Issue Date

01/29/2019

Effective Date

01/29/2019

Expiration Date

01/31/2021

City

DES PLAINES

State

Zip

60016

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/11/2021