TIMOTHY C VAN DEUSEN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

TIMOTHY C

Last Name

VAN DEUSEN

Business Name

TIMOTHY C VAN DEUSEN

Original Issue Date

08/15/1990

Effective Date

08/15/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006