KEVAN C HEROLD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

NOT RENEWED

Business

First Name

KEVAN C

Last Name

HEROLD

Suffix

Business Name

KEVAN C HEROLD MD

Original Issue Date

10/19/1983

Effective Date

10/19/1983

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006