GWYNETH A BRYANT Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****90

License Status

ACTIVE

Business

First Name

GWYNETH

Middle

Last Name

BRYANT

Business Name

GWYNETH A BRYANT

Original Issue Date

04/11/2011

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60602

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023