JENNIFER RAE THIEMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

JENNIFER

Middle

RAE

Last Name

THIEMAN

Suffix

Business Name

JENNIFER RAE THIEMAN MD

Original Issue Date

04/02/2007

Effective Date

04/21/2011

Expiration Date

07/31/2014

City

WESTERN SPRINGS

State

Zip

60558

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014