ROSS JOHN GOODFELLOW Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

CANCELLED

Business

First Name

ROSS

Middle

JOHN

Last Name

GOODFELLOW

Business Name

ROSS JOHN GOODFELLOW

Original Issue Date

07/16/2002

Effective Date

07/16/2002

Expiration Date

07/31/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006