DEBRA D SUSIE LATTNER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

First Name

DEBRA D SUSIE

Last Name

LATTNER

Business Name

DEBRA D SUSIE LATTNER

Original Issue Date

06/02/1986

Effective Date

09/28/2020

Expiration Date

07/31/2023

City

HAWTHORN WOODS

State

Zip

60047

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023