BAMBI RAE RADECKI WEYERS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

BAMBI

Middle

RAE RADECKI

Last Name

WEYERS

Business Name

BAMBI RAE RADECKI WEYERS

Original Issue Date

04/15/2008

Effective Date

04/15/2008

Expiration Date

07/31/2011

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011