AMY LYNNE BANULIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

AMY

Middle

LYNNE

Last Name

BANULIS

Suffix

Business Name

AMY LYNNE BANULIS MD

Original Issue Date

07/23/1998

Effective Date

07/23/1998

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006