MARISSA CAMILLE LYDIA DAVIS 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

Title

First Name

MARISSA

Middle

CAMILLE LYDIA

Last Name

DAVIS

Business Name

MARISSA CAMILLE LYDIA DAVIS MD

Original Issue Date

08/19/2025

Effective Date

08/19/2025

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/19/2025