MARY JEAN CANNON 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

MARY JEAN

Last Name

CANNON

Suffix

Business Name

MARY JEAN CANNON MD

Original Issue Date

08/20/1984

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021