COLIN DAVID RUDOLPH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

COLIN

Middle

DAVID

Last Name

RUDOLPH

Suffix

Business Name

COLIN DAVID RUDOLPH MD

Original Issue Date

01/25/2002

Effective Date

01/25/2002

Expiration Date

07/31/2005

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006