EMMA ANSELIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

Title

First Name

EMMA

Last Name

ANSELIN

Business Name

EMMA ANSELIN MD

Original Issue Date

05/08/2019

Effective Date

05/08/2019

Expiration Date

09/30/2020

City

NORTHBROOK

State

Zip

60062

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021