STANLEY P KOKOCKI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

STANLEY

Middle

Last Name

KOKOCKI

Suffix

Business Name

STANLEY P KOKOCKI MD

Original Issue Date

09/27/2019

Effective Date

09/27/2019

Expiration Date

09/30/2020

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021