MARIETTA J ABRAHAM 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

MARIETTA

Middle

Last Name

ABRAHAM

Business Name

MARIETTA J ABRAHAM MD

Original Issue Date

09/28/2010

Effective Date

09/28/2010

Expiration Date

07/31/2011

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020