DONALD JEFFREY BROCK DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

Title

First Name

DONALD

Middle

JEFFREY

Last Name

BROCK

Business Name

DONALD JEFFREY BROCK DO

Original Issue Date

12/31/2019

Effective Date

12/31/2019

Expiration Date

09/30/2020

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021