ANDREA DIANE BIRNBAUM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

ANDREA

Middle

DIANE

Last Name

BIRNBAUM

Suffix

Business Name

ANDREA DIANE BIRNBAUM MD

Original Issue Date

03/30/2009

Effective Date

05/16/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023