THEODORE D CHUNG 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

THEODORE

Middle

Last Name

CHUNG

Suffix

Business Name

THEODORE D CHUNG MD

Original Issue Date

08/30/1995

Effective Date

08/30/1995

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60616

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006