CARRIE DANIELLE FUNKHAUSER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

DANIELLE

Last Name

FUNKHAUSER

Suffix

Business Name

CARRIE DANIELLE FUNKHAUSER MD

Original Issue Date

09/09/2009

Effective Date

05/16/2014

Expiration Date

07/31/2017

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/01/2017