MERRICK JAY DONENBERG MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

Title

First Name

MERRICK

Middle

JAY

Last Name

DONENBERG

Business Name

MERRICK JAY DONENBERG MD

Original Issue Date

08/30/2016

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

OTTAWA

State

Zip

61350

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023