JENNIFER L LIEDEL 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

JENNIFER

Middle

Last Name

LIEDEL

Business Name

JENNIFER L LIEDEL

Original Issue Date

06/12/2002

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017