PRUDENCE HARTWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

PRUDENCE

Last Name

HARTWELL

Business Name

PRUDENCE HARTWELL MD

Original Issue Date

06/25/2018

Effective Date

06/25/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021