CAROLA E BONFANTE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

NOT RENEWED

Business

First Name

CAROLA

Middle

Last Name

BONFANTE

Business Name

CAROLA E BONFANTE

Original Issue Date

08/20/2002

Effective Date

08/20/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006