JEREMY MICHAEL VEENSTRA-VANDERWEELE 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

JEREMY

Middle

MICHAEL

Last Name

VEENSTRA-VANDERWEELE

Suffix

Business Name

JEREMY MICHAEL VEENSTRA-VANDERWEELE MD

Original Issue Date

03/11/2005

Effective Date

03/11/2005

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008