ANNA JANELLE BROADNAX MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

Title

First Name

ANNA

Middle

JANELLE

Last Name

BROADNAX

Business Name

ANNA JANELLE BROADNAX MD

Original Issue Date

06/25/2013

Effective Date

06/25/2013

Expiration Date

07/31/2014

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014