CHAD EDWARD CARLSON MD - Medical Doctor License in Illinois | # 125040684

CHAD EDWARD CARLSON MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040684

License Status

CANCELLED

Business

N

First Name

CHAD

Middle

EDWARD

Last Name

CARLSON

Suffix

MD

Business Name

CHAD EDWARD CARLSON MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006