TIMOTHY R VADEBONCOUER MD 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

TIMOTHY

Middle

Last Name

VADEBONCOUER

Suffix

Business Name

TIMOTHY R VADEBONCOUER MD

Original Issue Date

04/26/1991

Effective Date

04/16/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020