SARA A DIVALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

SARA

Middle

Last Name

DIVALL

Suffix

Business Name

SARA A DIVALL MD

Original Issue Date

10/16/2003

Effective Date

10/16/2003

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011