DANIEL JAMES DESTICHE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

Title

First Name

DANIEL

Middle

JAMES

Last Name

DESTICHE

Business Name

DANIEL JAMES DESTICHE MD

Original Issue Date

07/31/2023

Effective Date

07/31/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/31/2023