DEIDRE J ANDERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

DEIDRE J

Last Name

ANDERSON

Business Name

DEIDRE J ANDERSON

Original Issue Date

10/20/1995

Effective Date

05/07/2014

Expiration Date

07/31/2017

City

ARLINGTON HEIGHTS

State

Zip

60004

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017