ADAM MATTHEW PETRICH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

Title

First Name

ADAM

Middle

MATTHEW

Last Name

PETRICH

Business Name

ADAM MATTHEW PETRICH MD

Original Issue Date

06/23/2011

Effective Date

06/06/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017