PRUDENCE L GOURGUECHON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036062459

License Status

ACTIVE

Business

First Name

PRUDENCE

Middle

Last Name

GOURGUECHON

Suffix

Business Name

PRUDENCE L GOURGUECHON MD

Original Issue Date

07/01/1981

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60646

County

COOK

Ever Disciplined

LastModifiedDate

04/12/2023