OLGA GENIYEVNA KOZLOVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

Title

First Name

OLGA

Middle

GENIYEVNA

Last Name

KOZLOVA

Business Name

OLGA GENIYEVNA KOZLOVA MD

Original Issue Date

08/02/2019

Effective Date

08/02/2019

Expiration Date

09/30/2020

City

GLENVIEW

State

Zip

60025

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021