KONSTANTIN DAMIANOV BUKOV MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

KONSTANTIN

Middle

DAMIANOV

Last Name

BUKOV

Suffix

Business Name

KONSTANTIN DAMIANOV BUKOV MD

Original Issue Date

09/10/2008

Effective Date

09/10/2008

Expiration Date

07/31/2011

City

AURORA

State

Zip

60504

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011