LORA KOSIVZOFF DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****05

License Status

ACTIVE

Business

First Name

LORA

Last Name

KOSIVZOFF

Suffix

DPM

Business Name

LORA KOSIVZOFF DPM

Original Issue Date

03/04/1991

Effective Date

01/30/2025

Expiration Date

01/31/2027

City

CHICAGO

State

Zip

60610

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025