DIANA J GOODMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

Title

First Name

DIANA

Middle

Last Name

GOODMAN

Business Name

DIANA J GOODMAN MD

Original Issue Date

06/26/2014

Effective Date

06/26/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017