BRENT WILLIAM WHITED Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

BRENT

Middle

WILLIAM

Last Name

WHITED

Business Name

BRENT WILLIAM WHITED

Original Issue Date

04/06/2009

Effective Date

04/06/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011