TAMARA W CONGDON - Medical Doctor License in Illinois | # 125037505

TAMARA W CONGDON

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037505

License Status

EXPIRED

Business

N

First Name

TAMARA

Middle

W

Last Name

CONGDON

Business Name

TAMARA W CONGDON

Original Issue Date

05/06/1998

Effective Date

05/06/1998

Expiration Date

06/15/2001

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006