CARLITO V ORIG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

CARLITO V

Last Name

ORIG

Suffix

Business Name

CARLITO V ORIG MD

Original Issue Date

01/01/1997

Effective Date

06/10/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60638

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011