DANIEL GREGORY AMEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

GREGORY

Last Name

AMEN

Suffix

Business Name

DANIEL GREGORY AMEN MD

Original Issue Date

07/14/2017

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

BANNOCKBURN

State

Zip

60015

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021