OCTAVIO M LOPEZ Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

OCTAVIO M

Last Name

LOPEZ

Business Name

OCTAVIO M LOPEZ

Original Issue Date

01/31/1992

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021