KELLY SUSAN SKOUMAL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096752

License Status

NOT RENEWED

Business

First Name

KELLY SUSAN

Last Name

SKOUMAL

Business Name

KELLY SUSAN SKOUMAL

Original Issue Date

09/29/1997

Effective Date

09/29/1997

Expiration Date

07/31/1999

City

DES PLAINES

State

Zip

60016

County

COOK

Ever Disciplined

LastModifiedDate

10/20/2006