EMELIE T MEDALLE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

First Name

EMELIE

Middle

Last Name

MEDALLE

Business Name

EMELIE T MEDALLE

Original Issue Date

06/03/2004

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60642

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023