EDWIN G AVERY IV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****48

License Status

ACTIVE

Business

Title

First Name

EDWIN

Middle

Last Name

AVERY

Suffix

Business Name

EDWIN G AVERY IV MD

Original Issue Date

10/05/2022

Effective Date

07/27/2023

Expiration Date

07/31/2026

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/27/2023