JENNIFER REAVIS DECKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****50

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

REAVIS

Last Name

DECKER

Business Name

JENNIFER REAVIS DECKER MD

Original Issue Date

12/14/2011

Effective Date

12/14/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60647

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014