ELLEN L MOZURKEWICH 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

ELLEN L

Last Name

MOZURKEWICH

Business Name

ELLEN L MOZURKEWICH

Original Issue Date

09/28/1988

Effective Date

09/28/1988

Expiration Date

07/31/1993

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006