JACK LANCELOT LICHTOR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

CANCELLED

Business

First Name

JACK LANCELOT

Last Name

LICHTOR

Suffix

Business Name

JACK LANCELOT LICHTOR MD

Original Issue Date

09/11/1981

Effective Date

09/11/1981

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60655

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011