MARY BETH MADONNA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

First Name

MARY BETH

Last Name

MADONNA

Business Name

MARY BETH MADONNA

Original Issue Date

07/13/1993

Effective Date

07/04/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2023