ALISSA MICHELLE MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

ALISSA

Middle

MICHELLE

Last Name

MARTIN

Suffix

Business Name

ALISSA MICHELLE MARTIN MD

Original Issue Date

03/23/2009

Effective Date

07/19/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014