LAWRENCE H ITELD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

CANCELLED

Business

First Name

LAWRENCE

Middle

Last Name

ITELD

Business Name

LAWRENCE H ITELD

Original Issue Date

04/10/2003

Effective Date

04/10/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020