BRONWYN R RAE Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

ACTIVE

Business

First Name

BRONWYN R

Last Name

RAE

Business Name

BRONWYN R RAE

Original Issue Date

12/04/1992

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023