DARRYL ADAM ZUCKERMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

DARRYL ADAM

Last Name

ZUCKERMAN

Business Name

DARRYL ADAM ZUCKERMAN

Original Issue Date

10/03/1997

Effective Date

10/03/1997

Expiration Date

07/31/2002

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006