JAMIE AMANDA CHIN-THEODOROU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

Title

First Name

JAMIE

Middle

AMANDA

Last Name

CHIN-THEODOROU

Business Name

JAMIE AMANDA CHIN-THEODOROU MD

Original Issue Date

04/17/2019

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

NEW LENOX

State

Zip

60451

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/30/2023