KARL H TAKABAYASHI 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

KARL

Middle

Last Name

TAKABAYASHI

Business Name

KARL H TAKABAYASHI MD

Original Issue Date

10/29/2014

Effective Date

10/29/2014

Expiration Date

07/31/2017

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017