MITRA DEAN POORAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

Title

First Name

MITRA

Middle

DEAN

Last Name

POORAK

Business Name

MITRA DEAN POORAK MD

Original Issue Date

08/17/2022

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

DANVILLE

State

Zip

61832

County

VERMILION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/07/2023