PRAIRIE GLEN FAMILY MEDICINE SC Medical Corporation License verification

Business Entity

NOT RENEWED

License Type

Medical Corporation

Description

REGISTERED MEDICAL CORPORATION

License Number

042618350

License Status

NOT RENEWED

Business

Business Name

PRAIRIE GLEN FAMILY MEDICINE SC

Original Issue Date

09/29/2004

Effective Date

11/01/2010

Expiration Date

01/01/2012

City

GLENVIEW

State

Zip

60026

County

COOK

Ever Disciplined

LastModifiedDate

03/22/2012