COLLEEN PATRICIA DOHERTY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

Title

First Name

COLLEEN

Middle

PATRICIA

Last Name

DOHERTY

Business Name

COLLEEN PATRICIA DOHERTY MD

Original Issue Date

07/20/2011

Effective Date

07/20/2011

Expiration Date

07/31/2014

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020