JEREMY DOUGLAS COLLINS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

Title

First Name

JEREMY

Middle

DOUGLAS

Last Name

COLLINS

Business Name

JEREMY DOUGLAS COLLINS MD

Original Issue Date

04/04/2011

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021