MARTHA BONNIE PANKOVICH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

CANCELLED

Business

First Name

MARTHA

Middle

BONNIE

Last Name

PANKOVICH

Suffix

Business Name

MARTHA BONNIE PANKOVICH MD

Original Issue Date

06/29/2004

Effective Date

06/29/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011