ADRIENNE B NEITHARDT Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

CANCELLED

Business

First Name

ADRIENNE

Middle

Last Name

NEITHARDT

Business Name

ADRIENNE B NEITHARDT

Original Issue Date

07/18/2000

Effective Date

07/18/2000

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006