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Physician Last Name: | Pack | |||
Physician First Name: | A | |||
Physician Middle Name: | Stephen | |||
Address: | 283 Millwood Road Chappaqua Ny 10514 | |||
License Number: | 183669 | |||
License Type: | MD | |||
Year of Birth: | 1956 | |||
Effective Date: | 04/28/2000 | |||
Action Description for DOH Webpage: | License surrender | |||
Misconduct Description for DOH Webpage: | The physician did not contest the charge of administering a drug without due authorization or consent. | |||
License Limitations or Conditions for DOH Webpage: | ||||
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