BRIAN LEROY ANDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

NOT RENEWED

Business

Title

First Name

BRIAN

Middle

LEROY

Last Name

ANDERSON

Business Name

BRIAN LEROY ANDERSON MD

Original Issue Date

03/04/2010

Effective Date

07/29/2011

Expiration Date

07/31/2014

City

ELGIN

State

Zip

60123

County

KANE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014