SAMUEL DOREVITCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

SAMUEL

Last Name

DOREVITCH

Suffix

Business Name

SAMUEL DOREVITCH MD

Original Issue Date

09/05/1991

Effective Date

09/05/1991

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020