ANITA M ZACHARIAH Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

CANCELLED

Business

First Name

ANITA

Middle

Last Name

ZACHARIAH

Business Name

ANITA M ZACHARIAH

Original Issue Date

06/05/2003

Effective Date

06/05/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006