EKATERINA RAVIKOVICH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

EKATERINA

Last Name

RAVIKOVICH

Business Name

EKATERINA RAVIKOVICH

Original Issue Date

08/18/1999

Effective Date

08/18/1999

Expiration Date

07/31/2002

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006