FORREST PENDLETON ALLEN DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

Title

First Name

FORREST

Middle

PENDLETON

Last Name

ALLEN

Business Name

FORREST PENDLETON ALLEN DO

Original Issue Date

10/08/2014

Effective Date

05/23/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021