SAMUEL DOREVITCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

SAMUEL

Last Name

DOREVITCH

Suffix

Business Name

SAMUEL DOREVITCH MD

Original Issue Date

07/28/2008

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60666

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021