THOMAS J CZELATDKO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

THOMAS J

Last Name

CZELATDKO

Business Name

THOMAS J CZELATDKO

Original Issue Date

07/21/1995

Effective Date

07/21/1995

Expiration Date

07/31/2005

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006