CLYDE CARLOS ROUSE JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

NOT RENEWED

Business

First Name

CLYDE CARLOS

Last Name

ROUSE JR

Suffix

Business Name

CLYDE CARLOS ROUSE JR MD

Original Issue Date

04/13/1990

Effective Date

04/13/1990

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006