THEODOR IRVING KAUFMAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

CANCELLED

Business

First Name

THEODOR

Middle

IRVING

Last Name

KAUFMAN

Suffix

Business Name

THEODOR IRVING KAUFMAN MD

Original Issue Date

03/09/1999

Effective Date

03/09/1999

Expiration Date

07/31/2002

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006