AGNES D LATTIMER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

NOT RENEWED

Business

First Name

AGNES

Middle

DOLORES

Last Name

LATTIMER

Business Name

AGNES D LATTIMER

Original Issue Date

01/01/1997

Effective Date

07/11/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2014