GLENN DAVID PRENTICE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****91

License Status

NOT RENEWED

Business

First Name

GLENN DAVID

Last Name

PRENTICE

Suffix

Business Name

GLENN DAVID PRENTICE MD

Original Issue Date

10/19/1984

Effective Date

10/19/1984

Expiration Date

07/31/1990

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006