JEAN R GOGOLIN Medical Doctor License verification

Business Entity

INOPERATIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

INOPERATIVE

Business

First Name

JEAN R

Last Name

GOGOLIN

Business Name

JEAN R GOGOLIN

Original Issue Date

07/02/1996

Effective Date

07/02/1996

Expiration Date

07/31/1999

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006