DIANNE HENRY GLASS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

ACTIVE

Business

First Name

DIANNE

Middle

HENRY

Last Name

GLASS

Suffix

Business Name

DIANNE HENRY GLASS MD

Original Issue Date

06/30/2017

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023