LORRAINE JUSTINE PETRAK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

CANCELLED

Business

First Name

LORRAINE JUSTINE

Last Name

PETRAK

Suffix

Business Name

LORRAINE JUSTINE PETRAK MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

MERRIONETTE PARK

State

Zip

60803

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

04/17/2008