DEGAULLE HAILE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

DEGAULLE

Last Name

HAILE

Suffix

Business Name

DEGAULLE HAILE MD

Original Issue Date

02/13/2004

Effective Date

07/27/2011

Expiration Date

07/31/2014

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014