DALE A GOODMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

DALE A

Last Name

GOODMAN

Suffix

Business Name

DALE A GOODMAN MD

Original Issue Date

06/10/1991

Effective Date

06/10/1991

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006