KRISTEN M ZELLER HACK 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

KRISTEN

Middle

Last Name

ZELLER HACK

Business Name

KRISTEN M ZELLER HACK

Original Issue Date

01/08/2001

Effective Date

01/08/2001

Expiration Date

07/31/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006