MARY ELEANOR HEGSTROM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

ACTIVE

Business

Title

First Name

MARY

Middle

ELEANOR

Last Name

HEGSTROM

Business Name

MARY ELEANOR HEGSTROM DO

Original Issue Date

04/10/2014

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60623

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023