MAYA MARLENE GREEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

Title

First Name

MAYA

Middle

MARLENE

Last Name

GREEN

Business Name

MAYA MARLENE GREEN MD

Original Issue Date

05/23/2020

Effective Date

05/23/2020

Expiration Date

07/31/2023

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023