MICHELLE J DE VERA 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

First Name

MICHELLE

Middle

Last Name

DE VERA

Suffix

Business Name

MICHELLE J DE VERA MD

Original Issue Date

12/14/2001

Effective Date

12/14/2001

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006