DIANE W CROCKER MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072355

License Status

INACTIVE

Business

First Name

DIANE W

Last Name

CROCKER

Suffix

Business Name

DIANE W CROCKER MD

Original Issue Date

03/13/1986

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60610

County

COOK

Ever Disciplined

LastModifiedDate

04/17/2008