MARTIN EDMUND KLABACHA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

MARTIN EDMUND

Last Name

KLABACHA

Business Name

MARTIN EDMUND KLABACHA

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60629

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006