MICHAEL RENE CHARDACK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155352

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

RENE

Last Name

CHARDACK

Business Name

MICHAEL RENE CHARDACK MD

Original Issue Date

01/20/2021

Effective Date

01/20/2021

Expiration Date

07/31/2023

City

SALT LAKE CITY

State

Zip

84103

Ever Disciplined

LastModifiedDate

11/30/2023