JENNIFER MIRONICKI WRAY DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

MIRONICKI

Last Name

WRAY

Business Name

JENNIFER MIRONICKI WRAY DO

Original Issue Date

04/14/2014

Effective Date

04/14/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60615

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017