MONIQUE MAZAL BROTMAN Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

MONIQUE

Middle

MAZAL

Last Name

BROTMAN

Business Name

MONIQUE MAZAL BROTMAN

Original Issue Date

08/29/2003

Effective Date

02/03/2025

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/03/2025