VANESSA ILIENE PETRAK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

VANESSA

Middle

ILIENE

Last Name

PETRAK

Business Name

VANESSA ILIENE PETRAK MD

Original Issue Date

02/09/2022

Effective Date

04/25/2023

Expiration Date

07/31/2026

City

BURR RIDGE

State

Zip

60527

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/25/2023