BACHTRUC T TU Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

BACHTRUC

Middle

Last Name

Business Name

BACHTRUC T TU

Original Issue Date

10/04/2002

Effective Date

10/04/2002

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008