DAISY CHACKO THOMAS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

ACTIVE

Business

First Name

DAISY

Middle

CHACKO

Last Name

THOMAS

Suffix

Business Name

DAISY CHACKO THOMAS MD

Original Issue Date

07/20/2004

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023