TRACY W CANNON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

CANCELLED

Business

First Name

TRACY

Middle

Last Name

CANNON

Business Name

TRACY W CANNON

Original Issue Date

08/11/1997

Effective Date

08/11/1997

Expiration Date

07/31/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006