CHARLES R BLOCK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

NOT RENEWED

Business

First Name

CHARLES R

Last Name

BLOCK

Suffix

Business Name

CHARLES R BLOCK MD

Original Issue Date

04/20/1993

Effective Date

04/20/1993

Expiration Date

07/31/1996

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006