PAUL CORNELIUS VANDERBILT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

First Name

PAUL CORNELIUS

Last Name

VANDERBILT

Suffix

Business Name

PAUL CORNELIUS VANDERBILT MD

Original Issue Date

01/01/1997

Effective Date

04/22/2014

Expiration Date

07/31/2017

City

BLUE ISLAND

State

Zip

60406

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020