REVITAL MICHELLE MARCUS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

ACTIVE

Business

Title

First Name

REVITAL

Middle

MICHELLE

Last Name

MARCUS

Business Name

REVITAL MICHELLE MARCUS MD

Original Issue Date

08/10/2012

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

SKOKIE

State

Zip

60076

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023