JUSTIN EDWARD DVORAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

Title

First Name

JUSTIN

Middle

EDWARD

Last Name

DVORAK

Business Name

JUSTIN EDWARD DVORAK MD

Original Issue Date

10/02/2018

Effective Date

10/02/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021