FEODOR JUAN GLOSS DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

FEODOR

Middle

JUAN

Last Name

GLOSS

Suffix

Business Name

FEODOR JUAN GLOSS DO

Original Issue Date

07/16/2002

Effective Date

06/19/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2023