DIANE W CROCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

DIANE W

Last Name

CROCKER

Suffix

Business Name

DIANE W CROCKER MD

Original Issue Date

02/18/1987

Effective Date

02/18/1987

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006