THADDEUS W LIS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

THADDEUS W

Last Name

LIS

Suffix

Business Name

THADDEUS W LIS MD

Original Issue Date

08/25/1999

Effective Date

08/25/1999

Expiration Date

07/31/2002

City

GENEVA

State

Zip

60134

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006