DAVID A TRACE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

NOT RENEWED

Business

First Name

DAVID A

Last Name

TRACE

Suffix

Business Name

DAVID A TRACE MD

Original Issue Date

01/17/1985

Effective Date

08/20/2008

Expiration Date

07/31/2011

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020