JUDITH MALM DAVIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

JUDITH

Middle

MALM

Last Name

DAVIS

Suffix

Business Name

JUDITH MALM DAVIS MD

Original Issue Date

01/01/1997

Effective Date

08/19/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017