MARJORIE R EBENEZER MD MPH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

MARJORIE R

Last Name

EBENEZER MD MPH

Business Name

MARJORIE R EBENEZER MD MPH

Original Issue Date

05/17/1988

Effective Date

05/17/1988

Expiration Date

07/31/2002

City

OAK PARK

State

Zip

60301

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006