PIERS AMBROUSE BARRY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

Title

First Name

PIERS

Middle

AMBROUSE

Last Name

BARRY

Business Name

PIERS AMBROUSE BARRY MD

Original Issue Date

08/13/2013

Effective Date

08/13/2013

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60649

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/20/2016