JUAN C MACHANNAFORD MD 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

Title

First Name

JUAN

Middle

Last Name

MACHANNAFORD

Business Name

JUAN C MACHANNAFORD MD

Original Issue Date

06/01/2004

Effective Date

06/01/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011