JEFFREY P CHISDAK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

JEFFREY

Middle

Last Name

CHISDAK

Business Name

JEFFREY P CHISDAK

Original Issue Date

06/19/2006

Effective Date

07/09/2008

Expiration Date

07/31/2011

City

SAN DIEGO

State

Zip

92138

County

CALIFORNIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011