LOLITA M CRISOSTOMO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

LOLITA M

Last Name

CRISOSTOMO

Suffix

Business Name

LOLITA M CRISOSTOMO MD

Original Issue Date

10/02/1986

Effective Date

06/09/2014

Expiration Date

07/31/2017

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017