KIMBERLY LEONA JOHNSON DAVIS 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

KIMBERLY

Middle

LEONA

Last Name

JOHNSON DAVIS

Business Name

KIMBERLY LEONA JOHNSON DAVIS

Original Issue Date

04/30/2009

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60628

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021