KIMBERLY SUE SCANLON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

KIMBERLY SUE

Last Name

SCANLON

Suffix

Business Name

KIMBERLY SUE SCANLON DO

Original Issue Date

06/29/1997

Effective Date

06/19/2023

Expiration Date

07/31/2026

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/19/2023