GEOFFREY ALAN MODEST MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036053581

License Status

NOT RENEWED

Business

First Name

GEOFFREY ALAN

Last Name

MODEST

Suffix

Business Name

GEOFFREY ALAN MODEST MD

Original Issue Date

09/17/1976

Effective Date

09/17/1976

City

CHICAGO

State

Zip

60647

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006