DANIELLE RENAE DAVIS 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

First Name

DANIELLE

Middle

RENAE

Last Name

DAVIS

Suffix

Business Name

DANIELLE RENAE DAVIS MD

Original Issue Date

09/12/2008

Effective Date

09/12/2008

Expiration Date

07/31/2011

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011