MICHAEL R PRENDERGAST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

MICHAEL R

Last Name

PRENDERGAST

Business Name

MICHAEL R PRENDERGAST MD

Original Issue Date

08/23/1995

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2023