BOAZ AVITALL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

ACTIVE

Business

First Name

BOAZ

Last Name

AVITALL

Suffix

Business Name

BOAZ AVITALL MD

Original Issue Date

07/15/1994

Effective Date

04/13/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/13/2023