GARY LEE COHEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

GARY

Middle

LEE

Last Name

COHEN

Suffix

Business Name

GARY LEE COHEN MD

Original Issue Date

03/14/1990

Effective Date

03/14/1990

Expiration Date

07/31/1993

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006