MICHAEL ALLEN TERRY 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

MICHAEL

Middle

ALLEN

Last Name

TERRY

Business Name

MICHAEL ALLEN TERRY

Original Issue Date

07/26/2004

Effective Date

07/26/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020