KARIN E VANDER PLOEG BOOTH Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

ACTIVE

Business

First Name

KARIN

Middle

Last Name

VANDER PLOEG BOOTH

Business Name

KARIN E VANDER PLOEG BOOTH

Original Issue Date

08/04/2004

Effective Date

05/26/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60618

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/26/2023