CHANELE M BURGUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

First Name

CHANELE

Middle

Last Name

BURGUN

Suffix

Business Name

CHANELE M BURGUN MD

Original Issue Date

09/07/1999

Effective Date

09/07/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/09/2006