CHARLES DESHAZER 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

CHARLES

Last Name

DESHAZER

Suffix

Business Name

CHARLES DESHAZER MD

Original Issue Date

07/28/1986

Effective Date

07/28/1986

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020