MARY ELLEN B GAEKE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****44

License Status

CANCELLED

Business

First Name

MARY ELLEN B

Last Name

GAEKE

Suffix

Business Name

MARY ELLEN B GAEKE MD

Original Issue Date

01/01/1997

Expiration Date

09/01/1982

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006