BETHANY MARY JENGIC MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

BETHANY

Middle

MARY

Last Name

JENGIC

Business Name

BETHANY MARY JENGIC MD

Original Issue Date

04/01/2020

Effective Date

06/13/2023

Expiration Date

07/31/2026

City

PALOS HEIGHTS

State

Zip

60463

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/13/2023