CHAD T CARLSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

Last Name

CARLSON

Suffix

Business Name

CHAD T CARLSON MD

Original Issue Date

03/30/2001

Effective Date

03/30/2001

Expiration Date

07/31/2008

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008