CHARLI ATHENA T MELLA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****21

License Status

ACTIVE

Business

Title

First Name

CHARLI ATHENA

Middle

Last Name

MELLA

Business Name

CHARLI ATHENA T MELLA MD

Original Issue Date

05/27/2020

Effective Date

06/07/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/07/2023