BROCK DAVID ANDREATTA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

ACTIVE

Business

Title

First Name

BROCK

Middle

DAVID

Last Name

ANDREATTA

Business Name

BROCK DAVID ANDREATTA MD

Original Issue Date

08/27/2009

Effective Date

07/24/2023

Expiration Date

07/31/2026

City

NEW PHILADELPHIA

State

Zip

44663

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023