ADRIENNE MARTHA BALSAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

NOT RENEWED

Business

First Name

ADRIENNE

Middle

MARTHA

Last Name

BALSAM

Suffix

Business Name

ADRIENNE MARTHA BALSAM MD

Original Issue Date

11/19/1993

Effective Date

06/09/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020