IDA HEINTZ GRADOLPH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038692

License Status

NOT RENEWED

Business

First Name

IDA HEINTZ

Last Name

GRADOLPH

Suffix

Business Name

IDA HEINTZ GRADOLPH MD

Original Issue Date

09/16/1963

Effective Date

09/16/1963

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006