THERESA M CONYAC MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036129636

License Status

NOT RENEWED

Business

Title

First Name

THERESA

Middle

Last Name

CONYAC

Business Name

THERESA M CONYAC MD

Original Issue Date

02/17/2012

Effective Date

09/22/2020

Expiration Date

07/31/2023

City

ROCKWALL

State

Zip

75087

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/30/2023