CHARLES DESHAZER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017056

License Status

EXPIRED

Business

First Name

CHARLES

Last Name

DESHAZER

Suffix

Business Name

CHARLES DESHAZER MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

06/23/1986

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006