ERIC MATTHEW SIEGAL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

MATTHEW

Last Name

SIEGAL

Suffix

Business Name

ERIC MATTHEW SIEGAL MD

Original Issue Date

10/06/2010

Effective Date

07/12/2011

Expiration Date

07/31/2014

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/17/2014