JENNIFER LA VACCARE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

NOT RENEWED

Business

First Name

JENNIFER

Last Name

LA VACCARE

Business Name

JENNIFER LA VACCARE

Original Issue Date

08/09/1996

Effective Date

07/11/2011

Expiration Date

07/31/2014

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014