EFFIE DIS 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

EFFIE

Last Name

DIS

Suffix

Business Name

EFFIE DIS MD

Original Issue Date

03/29/1982

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

WHEELING

State

Zip

60090

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011