THEODORE KRUPIN MD 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

THEODORE

Last Name

KRUPIN

Suffix

Business Name

THEODORE KRUPIN MD

Original Issue Date

11/29/1989

Effective Date

07/27/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014