THERESA MARIE CZECH MD 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

Title

First Name

THERESA

Middle

MARIE

Last Name

CZECH

Business Name

THERESA MARIE CZECH MD

Original Issue Date

04/18/2014

Effective Date

04/17/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021