ANDREA SUE CLEM DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

ANDREA

Middle

SUE

Last Name

CLEM

Suffix

Business Name

ANDREA SUE CLEM DO

Original Issue Date

06/14/2012

Effective Date

06/14/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020