THEODORE SAMUEL EISENMAN 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

THEODORE SAMUEL

Last Name

EISENMAN

Suffix

Business Name

THEODORE SAMUEL EISENMAN MD

Original Issue Date

01/01/1997

Effective Date

05/05/2014

Expiration Date

07/31/2017

City

WILMETTE

State

Zip

60091

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017