INGRID KATHERINE MUDGE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

INGRID

Middle

KATHERINE

Last Name

MUDGE

Suffix

Business Name

INGRID KATHERINE MUDGE MD

Original Issue Date

06/29/1999

Effective Date

06/29/1999

Expiration Date

07/31/2002

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006