JILL A ODENTHAL SRACIC MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

JILL A

Middle

ODENTHAL

Last Name

SRACIC

Business Name

JILL A ODENTHAL SRACIC MD

Original Issue Date

01/31/2014

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

LIBERTYVILLE

State

Zip

60048

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021