EVA D RATAJCZAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

First Name

EVA

Middle

Last Name

RATAJCZAK

Suffix

Business Name

EVA D RATAJCZAK MD

Original Issue Date

03/10/2017

Effective Date

03/10/2017

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017