LESLIE J MINTZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

LESLIE J

Last Name

MINTZ

Suffix

Business Name

LESLIE J MINTZ MD

Original Issue Date

06/09/1987

Effective Date

06/09/1987

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006