WALLACE BRAND MENDELSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

CANCELLED

Business

First Name

WALLACE BRAND

Last Name

MENDELSON

Suffix

Business Name

WALLACE BRAND MENDELSON MD

Original Issue Date

03/21/1996

Effective Date

03/21/1996

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006