MAXIE MCDONOUGH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****54

License Status

ACTIVE

Business

Title

First Name

MAXIE

Last Name

MCDONOUGH

Business Name

MAXIE MCDONOUGH MD

Original Issue Date

03/19/2019

Effective Date

06/27/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60201

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/27/2023