CHARLES R POWELL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044893

License Status

EXPIRED

Business

First Name

CHARLES

Middle

Last Name

POWELL

Business Name

CHARLES R POWELL

Original Issue Date

06/24/2002

Effective Date

06/24/2002

Expiration Date

06/23/2008

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

06/26/2008