MAX MICHELSON BROCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

MAX

Middle

MICHELSON

Last Name

BROCK

Business Name

MAX MICHELSON BROCK MD

Original Issue Date

05/14/2019

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023