PEGGY ANNE SUPPLE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

PEGGY ANNE

Last Name

SUPPLE

Suffix

Business Name

PEGGY ANNE SUPPLE MD

Original Issue Date

01/01/1997

Effective Date

06/06/2023

Expiration Date

07/31/2026

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/06/2023