EKATERINA ALEKSANDROVNA KOLMOGOROVA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

Title

First Name

EKATERINA

Middle

ALEKSANDROVNA

Last Name

KOLMOGOROVA

Business Name

EKATERINA ALEKSANDROVNA KOLMOGOROVA MD

Original Issue Date

03/20/2020

Effective Date

03/20/2020

Expiration Date

07/31/2023

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023