PERPETUA T GOODALL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

ACTIVE

Business

First Name

PERPETUA

Middle

Last Name

GOODALL

Business Name

PERPETUA T GOODALL

Original Issue Date

07/19/2004

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023