URSINA R TEITELBAUM 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

URSINA

Middle

Last Name

TEITELBAUM

Business Name

URSINA R TEITELBAUM

Original Issue Date

04/05/2002

Effective Date

04/05/2002

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008