LISA DIANE CHODAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

First Name

LISA

Middle

DIANE

Last Name

CHODAK

Suffix

Business Name

LISA DIANE CHODAK MD

Original Issue Date

07/07/1999

Effective Date

07/07/1999

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008