KATHRYN L CARLSON - Medical Doctor License in Illinois | # 125047410

KATHRYN L CARLSON

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047410

License Status

CANCELLED

Business

N

First Name

KATHRYN

Middle

L

Last Name

CARLSON

Business Name

KATHRYN L CARLSON

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2007

State

IL

Specialty/Qualifier

Pediatrics

Ever Disciplined

N

LastModifiedDate

09/22/2006