JEANNINE T WALTERS Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

CANCELLED

Business

First Name

JEANNINE

Middle

Last Name

WALTERS

Business Name

JEANNINE T WALTERS

Original Issue Date

07/06/1998

Effective Date

07/06/1998

Expiration Date

07/31/2002

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006