OCTAVIA B KINCAID Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

ACTIVE

Business

First Name

OCTAVIA

Middle

Last Name

KINCAID

Business Name

OCTAVIA B KINCAID

Original Issue Date

01/17/2006

Effective Date

05/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/19/2023