MICHELLE ANN BARDACK 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

MICHELLE

Middle

ANN

Last Name

BARDACK

Suffix

Business Name

MICHELLE ANN BARDACK MD

Original Issue Date

10/16/2003

Effective Date

10/16/2003

Expiration Date

07/31/2008

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008