CHARLES L DICKENS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030793

License Status

NOT RENEWED

Business

First Name

CHARLES L

Last Name

DICKENS

Business Name

CHARLES L DICKENS

Original Issue Date

12/15/1993

Effective Date

12/15/1993

Expiration Date

12/08/1996

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006

Case Number

1993007557

Action

Probation

Discipline Start Date

12/09/1993

Discipline Reason

Substance abuse problem.