JEROME DALLAS WINEGARDEN III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

First Name

JEROME

Middle

DALLAS

Last Name

WINEGARDEN

Suffix

III MD

Business Name

JEROME DALLAS WINEGARDEN III MD

Original Issue Date

05/22/2000

Effective Date

05/22/2000

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006