KIMBERLY J MCINTOSH Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

CANCELLED

Business

First Name

KIMBERLY

Middle

Last Name

MCINTOSH

Business Name

KIMBERLY J MCINTOSH

Original Issue Date

04/15/2002

Effective Date

04/15/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006