MEREDITH AMANDA JESSICA JOHNSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

MEREDITH

Middle

AMANDA JESSICA

Last Name

JOHNSON

Business Name

MEREDITH AMANDA JESSICA JOHNSON MD

Original Issue Date

05/09/2020

Effective Date

04/28/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/28/2023