JEREMY RAIDER ESTRADA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

JEREMY

Middle

RAIDER

Last Name

ESTRADA

Business Name

JEREMY RAIDER ESTRADA MD

Original Issue Date

06/28/2012

Effective Date

06/28/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017