JACQUELINE BARDWELL 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

JACQUELINE

Last Name

BARDWELL

Suffix

Business Name

JACQUELINE BARDWELL MD

Original Issue Date

11/14/1985

Effective Date

08/01/2011

Expiration Date

07/31/2014

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014