SOPHIA Y ROSTOVTSEV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****39

License Status

NOT RENEWED

Business

First Name

SOPHIA

Middle

Last Name

ROSTOVTSEV

Suffix

Business Name

SOPHIA Y ROSTOVTSEV MD

Original Issue Date

09/06/2002

Effective Date

09/06/2002

Expiration Date

07/31/2008

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020