CORAZON B CUSTODIO MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

First Name

CORAZON B

Last Name

CUSTODIO

Suffix

Business Name

CORAZON B CUSTODIO MD

Original Issue Date

11/15/1993

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023