INGRID C ANTONSEN MD - Medical Doctor License in Illinois | # 125020835

INGRID C ANTONSEN MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020835

License Status

EXPIRED

Business

N

First Name

INGRID C

Last Name

ANTONSEN

Suffix

MD

Business Name

INGRID C ANTONSEN MD

Original Issue Date

05/13/1987

Effective Date

05/13/1987

Expiration Date

07/01/1990

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006