JEFFREY W MEINCKE-REZA 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

First Name

JEFFREY

Middle

Last Name

MEINCKE-REZA

Suffix

Business Name

JEFFREY W MEINCKE-REZA MD

Original Issue Date

12/12/2001

Effective Date

12/12/2001

Expiration Date

07/31/2005

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011