SUSAN BEAUSOLEIL BOGRAD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

CANCELLED

Business

First Name

SUSAN BEAUSOLEIL

Last Name

BOGRAD

Business Name

SUSAN BEAUSOLEIL BOGRAD

Original Issue Date

08/09/1988

Effective Date

08/09/1988

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006