KRISTEN JEAN CARROLL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

KRISTEN

Middle

JEAN

Last Name

CARROLL

Business Name

KRISTEN JEAN CARROLL MD

Original Issue Date

02/08/2021

Effective Date

02/08/2021

Expiration Date

07/31/2023

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023