BOBY GEORGE THECKEDATH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

NOT RENEWED

Business

First Name

BOBY

Middle

GEORGE

Last Name

THECKEDATH

Suffix

Business Name

BOBY GEORGE THECKEDATH MD

Original Issue Date

07/19/2001

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021