JULIE SUZANNE MOLDENHAUER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

CANCELLED

Business

First Name

JULIE SUZANNE

Last Name

MOLDENHAUER

Suffix

Business Name

JULIE SUZANNE MOLDENHAUER MD

Original Issue Date

05/11/2005

Effective Date

05/11/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011