ANGEL D LEAKE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

First Name

ANGEL

Middle

Last Name

LEAKE

Business Name

ANGEL D LEAKE

Original Issue Date

05/31/2005

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60628

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2023