CLEMENT ST PATRICK ROSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

Title

First Name

CLEMENT

Middle

ST PATRICK

Last Name

ROSE

Business Name

CLEMENT ST PATRICK ROSE MD

Original Issue Date

08/21/1987

Effective Date

07/07/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020