DANIELLE NICOLE ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****33

License Status

NOT RENEWED

Business

Title

First Name

DANIELLE

Middle

NICOLE

Last Name

ANDERSON

Business Name

DANIELLE NICOLE ANDERSON MD

Original Issue Date

07/17/2015

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

TINLEY PARK

State

Zip

60477

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021