DOUGLAS R WITHAM 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

DOUGLAS R

Last Name

WITHAM

Suffix

Business Name

DOUGLAS R WITHAM MD

Original Issue Date

01/01/1997

Effective Date

05/02/2011

Expiration Date

07/31/2014

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014