THEODORE D CHUNG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****14

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

Last Name

CHUNG

Suffix

Business Name

THEODORE D CHUNG MD

Original Issue Date

05/08/1998

Effective Date

05/08/1998

Expiration Date

07/31/2002

City

LA GRANGE

State

Zip

60525

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006