TOM DEKLAJ 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

Title

First Name

TOM

Last Name

DEKLAJ

Business Name

TOM DEKLAJ MD

Original Issue Date

02/28/2008

Effective Date

02/28/2008

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011