JEAN RICCI GOODMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

Title

First Name

JEAN

Middle

RICCI

Last Name

GOODMAN

Business Name

JEAN RICCI GOODMAN MD

Original Issue Date

08/13/2012

Effective Date

09/09/2020

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60603

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023