MICHAEL ZDENEK DAVID Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

ZDENEK

Last Name

DAVID

Business Name

MICHAEL ZDENEK DAVID

Original Issue Date

06/30/2004

Effective Date

05/02/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021