MICHAEL THOMAS CHURCHWELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

THOMAS

Last Name

CHURCHWELL

Business Name

MICHAEL THOMAS CHURCHWELL MD

Original Issue Date

08/22/2011

Effective Date

07/21/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017