JOSHUA KAVIN MODDER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

NOT RENEWED

Business

First Name

JOSHUA

Middle

KAVIN

Last Name

MODDER

Suffix

Business Name

JOSHUA KAVIN MODDER MD

Original Issue Date

05/23/2006

Effective Date

05/23/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008