ANGEL D LEAKE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

First Name

ANGEL

Middle

Last Name

LEAKE

Business Name

ANGEL D LEAKE

Original Issue Date

09/07/2011

Effective Date

09/07/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60628

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020