LEE A CROCKER MD 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

LEE A

Last Name

CROCKER

Suffix

Business Name

LEE A CROCKER MD

Original Issue Date

01/25/1988

Effective Date

01/25/1988

Expiration Date

07/31/1990

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006