BRIAN P DICKOVER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

DICKOVER

Suffix

Business Name

BRIAN P DICKOVER MD

Original Issue Date

07/19/2004

Effective Date

07/19/2004

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008