LAWRENCE M LAVINE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

LAWRENCE M

Last Name

LAVINE

Suffix

Business Name

LAWRENCE M LAVINE MD

Original Issue Date

04/09/2004

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017