THOMAS EDWIN KLARQUIST MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

First Name

THOMAS

Middle

EDWIN

Last Name

KLARQUIST

Suffix

Business Name

THOMAS EDWIN KLARQUIST MD

Original Issue Date

01/13/2000

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/18/2023