THOMAS M PROSE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

Last Name

PROSE

Suffix

Business Name

THOMAS M PROSE MD

Original Issue Date

12/22/1997

Effective Date

12/22/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020