TREVOR W LISSOOS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

TREVOR W

Last Name

LISSOOS

Business Name

TREVOR W LISSOOS

Original Issue Date

05/06/1988

Effective Date

04/19/2017

Expiration Date

09/30/2020

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021