T ERIC SCHACKOW MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

NOT RENEWED

Business

First Name

Middle

ERIC

Last Name

SCHACKOW

Suffix

Business Name

T ERIC SCHACKOW MD

Original Issue Date

04/14/1999

Effective Date

05/22/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017