EVAN AUGUSTINE DOUGHERTY 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

Title

First Name

EVAN

Middle

AUGUSTINE

Last Name

DOUGHERTY

Business Name

EVAN AUGUSTINE DOUGHERTY MD

Original Issue Date

03/10/2015

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

WESTMONT

State

Zip

60559

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023