LOLITA M CRISOSTOMO 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

LOLITA M

Last Name

CRISOSTOMO

Suffix

Business Name

LOLITA M CRISOSTOMO MD

Original Issue Date

09/09/1987

Effective Date

09/09/1987

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017