ALLEN RAFAEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

ALLEN

Last Name

RAFAEL

Suffix

Business Name

ALLEN RAFAEL MD

Original Issue Date

05/29/1997

Effective Date

05/29/1997

Expiration Date

07/31/2005

City

OAK BROOK

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006