MERVYN JAY WEIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

MERVYN

Middle

JAY

Last Name

WEIS

Suffix

Business Name

MERVYN JAY WEIS MD

Original Issue Date

01/01/1997

Effective Date

08/26/2008

Expiration Date

07/31/2011

City

LAKE FOREST

State

Zip

60045

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011