SUSAN K DUDERSTADT Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036091691

License Status

NOT RENEWED

Business

First Name

SUSAN K

Last Name

DUDERSTADT

Business Name

SUSAN K DUDERSTADT

Original Issue Date

08/23/1995

Effective Date

08/23/1995

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006