LISA MARIE BORKOWSKI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

CANCELLED

Business

First Name

LISA

Middle

MARIE

Last Name

BORKOWSKI

Suffix

Business Name

LISA MARIE BORKOWSKI MD

Original Issue Date

05/24/1999

Effective Date

05/24/1999

Expiration Date

07/31/2005

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006