EVAN J ANDERSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

EVAN

Middle

Last Name

ANDERSON

Business Name

EVAN J ANDERSON

Original Issue Date

04/14/2006

Effective Date

04/18/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

11/17/2014