CORNE VAN DER WALT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

NOT RENEWED

Business

Title

First Name

CORNE

Last Name

VAN DER WALT

Business Name

CORNE VAN DER WALT MD

Original Issue Date

04/11/2011

Effective Date

06/18/2014

Expiration Date

07/31/2017

City

GLENVIEW

State

Zip

60025

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017