MICHAEL W COLGROVE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

Last Name

COLGROVE

Business Name

MICHAEL W COLGROVE

Original Issue Date

07/10/2003

Effective Date

07/25/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017