DONOVAN C POLACK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

First Name

DONOVAN C

Last Name

POLACK

Suffix

Business Name

DONOVAN C POLACK MD

Original Issue Date

05/11/1988

Effective Date

06/14/2023

Expiration Date

07/31/2026

City

ST LOUIS

State

Zip

63136

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/14/2023