AGNES M INTAN-YOGYA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036064473

License Status

NOT RENEWED

Business

First Name

AGNES M

Last Name

INTAN-YOGYA

Suffix

Business Name

AGNES M INTAN-YOGYA MD

Original Issue Date

06/17/1982

Effective Date

06/17/1982

Expiration Date

07/31/2002

City

COUNTRY CLUB HILLS

State

Zip

60478

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006