ALEXANDER N ROUTCHENKOV Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

CANCELLED

Business

First Name

ALEXANDER

Middle

Last Name

ROUTCHENKOV

Business Name

ALEXANDER N ROUTCHENKOV

Original Issue Date

03/14/2003

Effective Date

03/14/2003

Expiration Date

07/31/2005

City

LAGRANGE

State

Zip

60525

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006