DANIEL HENRY POLK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

HENRY

Last Name

POLK

Suffix

Business Name

DANIEL HENRY POLK MD

Original Issue Date

07/15/1996

Effective Date

05/06/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020