DIEGO ANDRES MEDVEDOFSKY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****82

License Status

NOT RENEWED

Business

Title

First Name

DIEGO

Middle

ANDRES

Last Name

MEDVEDOFSKY

Business Name

DIEGO ANDRES MEDVEDOFSKY MD

Original Issue Date

09/29/2016

Effective Date

09/29/2016

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020