THEODORE J GALVANI JR 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

THEODORE

Middle

Last Name

GALVANI

Suffix

JR MD

Business Name

THEODORE J GALVANI JR MD

Original Issue Date

12/05/1994

Effective Date

04/05/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

1994004588

Action

Probation

Discipline Start Date

12/05/1994

Discipline Reason

License issued on probation due to a history of alcohol and substance abuse.