ETHEL SUSAN HERSKOVIC DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

Title

First Name

ETHEL

Middle

SUSAN

Last Name

HERSKOVIC

Business Name

ETHEL SUSAN HERSKOVIC DO

Original Issue Date

07/12/2012

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023