MOSHE DISSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

Title

First Name

MOSHE

Last Name

DISSEN

Business Name

MOSHE DISSEN MD

Original Issue Date

08/02/2019

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023