CANDICE MARIE LEACH 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

Title

First Name

CANDICE

Middle

MARIE

Last Name

LEACH

Business Name

CANDICE MARIE LEACH MD

Original Issue Date

06/17/2016

Effective Date

06/17/2016

Expiration Date

07/31/2017

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017