EMILY J SU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

Last Name

Business Name

EMILY J SU

Original Issue Date

08/03/2004

Effective Date

05/07/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017