TRACEY M DAVENPORT MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036114303

License Status

ACTIVE

Business

First Name

TRACEY

Middle

Last Name

DAVENPORT

Suffix

Business Name

TRACEY M DAVENPORT MD

Original Issue Date

08/02/2005

Effective Date

05/06/2023

Expiration Date

07/31/2026

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

05/06/2023