MOLLY BENNETTE MORAVEK 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

Title

First Name

MOLLY

Middle

BENNETTE

Last Name

MORAVEK

Business Name

MOLLY BENNETTE MORAVEK MD

Original Issue Date

03/28/2012

Effective Date

05/29/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017