THEODORE R VANDELLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036021477

License Status

NOT RENEWED

Business

First Name

THEODORE R

Last Name

VANDELLEN

Suffix

Business Name

THEODORE R VANDELLEN MD

Original Issue Date

08/03/1936

Effective Date

08/03/1936

Expiration Date

07/01/1982

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006