THEODORE S URBANSKI MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

INACTIVE

Business

First Name

THEODORE

Middle

Last Name

URBANSKI

Suffix

Business Name

THEODORE S URBANSKI MD

Original Issue Date

05/04/1999

Effective Date

05/04/1999

Expiration Date

07/31/2005

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/09/2006