ENRIQUE D POLANCO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Middle

Last Name

POLANCO

Suffix

Business Name

ENRIQUE D POLANCO MD

Original Issue Date

07/19/2001

Effective Date

07/19/2001

Expiration Date

07/31/2008

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008