JEANIE M BRANCONI 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

First Name

JEANIE M

Last Name

BRANCONI

Business Name

JEANIE M BRANCONI

Original Issue Date

05/11/1994

Effective Date

05/11/1994

Expiration Date

07/31/2002

City

RIVER GROVE

State

Zip

60171

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006