CHARLES CARROLL IV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

CHARLES

Last Name

CARROLL IV

Suffix

Business Name

CHARLES CARROLL IV MD

Original Issue Date

06/24/1988

Effective Date

08/30/2023

Expiration Date

07/31/2026

City

DELAPLANE

State

Zip

20144

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/30/2023