THEODORE EDMUND TE PAS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

First Name

THEODORE EDMUND

Last Name

TE PAS

Business Name

THEODORE EDMUND TE PAS

Original Issue Date

12/08/1988

Effective Date

12/08/1988

Expiration Date

07/31/2005

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006