ANDREA MICHELLE BACON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

First Name

ANDREA MICHELLE

Last Name

BACON

Suffix

Business Name

ANDREA MICHELLE BACON MD

Original Issue Date

04/28/1997

Effective Date

07/05/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/05/2023