ANNE EVELYN MISSAVAGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

ANNE

Middle

EVELYN

Last Name

MISSAVAGE

Suffix

Business Name

ANNE EVELYN MISSAVAGE MD

Original Issue Date

05/22/2000

Effective Date

05/22/2000

Expiration Date

07/31/2005

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006