ANN GAEL DEBORAH PRIVERT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****10

License Status

NOT RENEWED

Business

Title

First Name

ANN GAEL

Middle

DEBORAH

Last Name

PRIVERT

Business Name

ANN GAEL DEBORAH PRIVERT MD

Original Issue Date

10/24/2017

Effective Date

10/24/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021