GREGORY JOSEPH CONRAD - Medical Doctor License in Illinois | # 125047284

GREGORY JOSEPH CONRAD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047284

License Status

EXPIRED

Business

N

First Name

GREGORY

Middle

JOSEPH

Last Name

CONRAD

Business Name

GREGORY JOSEPH CONRAD

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/30/2007

State

IL

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

N

LastModifiedDate

07/03/2007