MICHAEL RENE CHARDACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****25

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

RENE

Last Name

CHARDACK

Business Name

MICHAEL RENE CHARDACK MD

Original Issue Date

01/26/2021

Effective Date

01/26/2021

Expiration Date

07/31/2023

City

ROCKFORD

State

Zip

61103

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023