CARMEN D CHASE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

NOT RENEWED

Business

First Name

CARMEN

Middle

Last Name

CHASE

Business Name

CARMEN D CHASE

Original Issue Date

07/13/2004

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

NORMAL

State

Zip

61761

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021