ANDREW RUSSELL WEISS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

First Name

ANDREW

Middle

RUSSELL

Last Name

WEISS

Suffix

Business Name

ANDREW RUSSELL WEISS MD

Original Issue Date

05/28/1998

Effective Date

05/28/1998

Expiration Date

07/31/2008

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008