MARIE RAPHAELLE MONA JEAN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

Title

First Name

MARIE RAPHAELLE

Middle

MONA

Last Name

JEAN

Business Name

MARIE RAPHAELLE MONA JEAN MD

Original Issue Date

08/24/2022

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61104

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/11/2025