TED G THACHENKARY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

TED

Middle

Last Name

THACHENKARY

Business Name

TED G THACHENKARY MD

Original Issue Date

09/01/2005

Effective Date

09/01/2005

Expiration Date

07/31/2008

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020