THEODORE BRETT JEFFERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

First Name

THEODORE

Middle

BRETT

Last Name

JEFFERSON

Suffix

Business Name

THEODORE BRETT JEFFERSON MD

Original Issue Date

03/07/2005

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60613

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023