IDAH M CANNON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

IDAH M

Last Name

CANNON

Suffix

Business Name

IDAH M CANNON MD

Original Issue Date

08/17/1998

Effective Date

08/17/1998

Expiration Date

07/31/1999

City

HARVEY

State

Zip

60426

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006