DIANA BOLOTIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

First Name

DIANA

Last Name

BOLOTIN

Suffix

Business Name

DIANA BOLOTIN MD

Original Issue Date

03/17/2010

Effective Date

05/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/11/2023