FRANK O PETKOVICH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

FRANK O

Last Name

PETKOVICH

Business Name

FRANK O PETKOVICH

Original Issue Date

09/22/2005

Effective Date

09/22/2005

Expiration Date

07/31/2008

City

BELLEVILLE

State

Zip

62220

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020