IRINA KOSTOVA DIMITROVA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

Title

First Name

IRINA

Middle

KOSTOVA

Last Name

DIMITROVA

Business Name

IRINA KOSTOVA DIMITROVA MD

Original Issue Date

04/27/2018

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/26/2023