BRENDA L RAPHAEL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****19

License Status

NOT RENEWED

Business

First Name

BRENDA L

Last Name

RAPHAEL

Business Name

BRENDA L RAPHAEL

Original Issue Date

07/02/1993

Effective Date

07/02/1993

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006