KIMBERLY A DETTLOFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

KIMBERLY A

Last Name

DETTLOFF

Suffix

Business Name

KIMBERLY A DETTLOFF MD

Original Issue Date

06/09/1993

Effective Date

05/19/2011

Expiration Date

07/31/2014

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014