LESTELLA DOROTHY BELL BIVENS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

LESTELLA

Middle

DOROTHY BELL

Last Name

BIVENS

Business Name

LESTELLA DOROTHY BELL BIVENS MD

Original Issue Date

08/29/2023

Effective Date

08/29/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2023