CHARLES M VAN SLAMBROUCK MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058083

License Status

CANCELLED

Business

Title

First Name

CHARLES

Middle

Last Name

VAN SLAMBROUCK

Business Name

CHARLES M VAN SLAMBROUCK MD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

HAZEL CREST

State

Zip

60429

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

05/18/2010