DANIEL LEE SURDELL JR MD 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

DANIEL

Middle

LEE

Last Name

SURDELL

Suffix

JR MD

Business Name

DANIEL LEE SURDELL JR MD

Original Issue Date

03/02/2006

Effective Date

03/02/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008