DAVID S ROSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

ROSEN

Business Name

DAVID S ROSEN

Original Issue Date

09/24/2009

Effective Date

09/24/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011