CHARLES L DICKENS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****66

License Status

NOT RENEWED

Business

First Name

CHARLES L

Last Name

DICKENS

Business Name

CHARLES L DICKENS

Original Issue Date

12/12/1996

Effective Date

12/12/1996

Expiration Date

07/31/1999

City

ALGONQUIN

State

Zip

60102

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006