PIA B LISLE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

NOT RENEWED

Business

First Name

PIA

Middle

Last Name

LISLE

Business Name

PIA B LISLE

Original Issue Date

01/02/2007

Effective Date

01/02/2007

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008