KENNETH SAMUEL POLONSKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

KENNETH SAMUEL

Last Name

POLONSKY

Suffix

Business Name

KENNETH SAMUEL POLONSKY MD

Original Issue Date

01/01/1997

Effective Date

03/11/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020