CHANTAL SALIM LUTFALLAH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

CHANTAL SALIM

Last Name

LUTFALLAH

Suffix

Business Name

CHANTAL SALIM LUTFALLAH MD

Original Issue Date

06/15/1999

Effective Date

06/15/1999

Expiration Date

07/31/2005

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006