KATRINA T LAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

ACTIVE

Business

Title

First Name

KATRINA

Middle

Last Name

LAKE

Business Name

KATRINA T LAKE MD

Original Issue Date

07/14/2016

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

COUNTRY CLUB HILLS

State

Zip

60478

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023