CHARLES DESHAZER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072675

License Status

NOT RENEWED

Business

First Name

CHARLES

Last Name

DESHAZER

Suffix

Business Name

CHARLES DESHAZER MD

Original Issue Date

05/02/1986

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021