CHARLES MARSHALL LIEDER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

Title

First Name

CHARLES

Middle

MARSHALL

Last Name

LIEDER

Business Name

CHARLES MARSHALL LIEDER DO

Original Issue Date

02/25/2015

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

MORTON GROVE

State

Zip

60053

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023