MAREK T DIDLUCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

First Name

MAREK

Middle

Last Name

DIDLUCH

Suffix

Business Name

MAREK T DIDLUCH MD

Original Issue Date

07/19/2004

Effective Date

07/19/2004

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60618

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020