EGON MICHAEL DOPPENBERG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****77

License Status

ACTIVE

Business

First Name

EGON

Middle

MICHAEL

Last Name

DOPPENBERG

Suffix

Business Name

EGON MICHAEL DOPPENBERG MD

Original Issue Date

04/15/2005

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023