DONALD G DICKEN 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

First Name

DONALD G

Last Name

DICKEN

Suffix

Business Name

DONALD G DICKEN MD

Original Issue Date

03/02/1990

Effective Date

03/02/1990

Expiration Date

07/31/1993

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006