JAY ADAM GOTTFRIED 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

JAY

Middle

ADAM

Last Name

GOTTFRIED

Business Name

JAY ADAM GOTTFRIED

Original Issue Date

10/13/2004

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021