EDWARD LYLE PASSEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

ACTIVE

Business

First Name

EDWARD LYLE

Last Name

PASSEN

Suffix

Business Name

EDWARD LYLE PASSEN MD

Original Issue Date

01/04/1984

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023