ANDREW PHILLIP CARLSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

Title

First Name

ANDREW

Middle

PHILLIP

Last Name

CARLSON

Business Name

ANDREW PHILLIP CARLSON MD

Original Issue Date

06/22/2011

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017