THEODORE RAYMOND MATHENY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

RAYMOND

Last Name

MATHENY

Suffix

Business Name

THEODORE RAYMOND MATHENY MD

Original Issue Date

07/24/2000

Effective Date

07/24/2000

Expiration Date

07/31/2002

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006