JOAN MIEDEMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

Title

First Name

JOAN

Last Name

MIEDEMA

Business Name

JOAN MIEDEMA MD

Original Issue Date

10/24/2012

Effective Date

07/17/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60610

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020