MARY ELIZABETH LAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

ACTIVE

Business

First Name

MARY

Middle

ELIZABETH

Last Name

LAKE

Suffix

Business Name

MARY ELIZABETH LAKE MD

Original Issue Date

06/19/2000

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023