MITZI R KROCKOVER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021036

License Status

EXPIRED

Business

First Name

MITZI R

Last Name

KROCKOVER

Business Name

MITZI R KROCKOVER

Original Issue Date

05/28/1987

Effective Date

05/28/1987

Expiration Date

06/23/1990

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006