TIMOTHY CLIFFORD CARLL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

ACTIVE

Business

Title

First Name

TIMOTHY

Middle

CLIFFORD

Last Name

CARLL

Business Name

TIMOTHY CLIFFORD CARLL MD

Original Issue Date

01/18/2022

Effective Date

05/24/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/24/2023