KIMBERLY LEONA JOHNSON DAVIS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

KIMBERLY

Middle

LEONA

Last Name

JOHNSON DAVIS

Business Name

KIMBERLY LEONA JOHNSON DAVIS

Original Issue Date

08/11/2020

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

EVERGREEN PK

State

Zip

60805

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/25/2023