LAUREL ETHERIDGE DOHERTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

LAUREL ETHERIDGE

Last Name

DOHERTY

Suffix

Business Name

LAUREL ETHERIDGE DOHERTY MD

Original Issue Date

01/01/1997

Effective Date

05/06/2014

Expiration Date

07/31/2017

City

NORTHFIELD

State

Zip

60093

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017