STANFORD ROSEN Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

STANFORD

Last Name

ROSEN

Business Name

STANFORD ROSEN

Original Issue Date

09/10/1981

Effective Date

09/10/1981

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60630

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006