KURTIS DAVID CARLOCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

Title

First Name

KURTIS

Middle

DAVID

Last Name

CARLOCK

Business Name

KURTIS DAVID CARLOCK MD

Original Issue Date

04/08/2024

Effective Date

04/08/2024

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/26/2024