BELLA K BUKOWSKI Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

BELLA

Middle

Last Name

BUKOWSKI

Business Name

BELLA K BUKOWSKI

Original Issue Date

08/19/2003

Effective Date

08/19/2003

Expiration Date

07/31/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006