EUGENE LUBIN DERLACKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

EUGENE LUBIN

Last Name

DERLACKI

Suffix

Business Name

EUGENE LUBIN DERLACKI MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006