GENIE ELLEN ROOSEVELT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036084654

License Status

NOT RENEWED

Business

First Name

GENIE ELLEN

Last Name

ROOSEVELT

Suffix

Business Name

GENIE ELLEN ROOSEVELT MD

Original Issue Date

07/01/1992

Effective Date

07/01/1992

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006