MITZI R KROCKOVER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

MITZI R

Last Name

KROCKOVER

Business Name

MITZI R KROCKOVER

Original Issue Date

02/09/1989

Effective Date

02/09/1989

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006