AMY R EVENSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

AMY

Middle

Last Name

EVENSON

Suffix

Business Name

AMY R EVENSON MD

Original Issue Date

04/17/2007

Effective Date

07/14/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60654

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011