STEVEN G POTACZEK 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

STEVEN G

Last Name

POTACZEK

Suffix

Business Name

STEVEN G POTACZEK MD

Original Issue Date

11/25/1987

Effective Date

09/28/2020

Expiration Date

07/31/2023

City

GALESBURG

State

Zip

61401

County

KNOX

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023