TERRY S CHONGULIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

Last Name

CHONGULIA

Suffix

Business Name

TERRY S CHONGULIA MD

Original Issue Date

06/18/1998

Effective Date

06/18/1998

Expiration Date

07/31/2005

City

BARRINGTON

State

Zip

60010

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/09/2006