ANDY AGEN DAVIS MD SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042005754

License Status

NOT RENEWED

Business

Business Name

ANDY AGEN DAVIS MD SC

Original Issue Date

03/01/1985

Effective Date

11/19/2015

Expiration Date

01/01/2017

City

CHICAGO

State

Zip

60619

County

COOK

Ever Disciplined

LastModifiedDate

05/10/2017