JEROME GABRIEL GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

JEROME GABRIEL

Last Name

GREEN

Suffix

Business Name

JEROME GABRIEL GREEN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006