EMILY CATHERINE BELLAVANCE 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

First Name

EMILY

Middle

CATHERINE

Last Name

BELLAVANCE

Business Name

EMILY CATHERINE BELLAVANCE

Original Issue Date

03/18/2008

Effective Date

03/18/2008

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011