| | Physician Last Name: | Buckley, Jr |
| | Physician First Name: | Charles |
| | Physician Middle Name: | P |
| | Address: | 1561 Jeanel Lane
Aurora, Illinois 60504 |
| | License Number: | 124026 |
| | License Type: | MD |
| | Year of Birth: |
1947
|
| | Effective Date: | 08/21/2001 |
| | Action Description for DOH Webpage: | License surrender |
| | Misconduct Description for DOH Webpage: | This action is a modification of the penalty previously imposed on July 31, 1997 by the New York State Board for Professional Medical Conduct Order #97-179 where he admitted he was disciplined by the Iowa State Board of Medical Examiners for having signed and submitted Medicaid and Medicare claim forms falsely certifying that he provided psychotherapy services. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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