CLYDE WILLIS PHILLIPS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

CLYDE WILLIS

Last Name

PHILLIPS

Suffix

Business Name

CLYDE WILLIS PHILLIPS MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006