THEODORE ARTHUR SLATER III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****85

License Status

NOT RENEWED

Business

First Name

THEODORE

Middle

ARTHUR

Last Name

SLATER

Suffix

III MD

Business Name

THEODORE ARTHUR SLATER III MD

Original Issue Date

05/19/2003

Effective Date

05/19/2003

Expiration Date

07/31/2008

City

WOODRIDGE

State

Zip

60517

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008