TERRY S CHONGULIA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096957

License Status

NOT RENEWED

Business

First Name

TERRY

Middle

Last Name

CHONGULIA

Suffix

Business Name

TERRY S CHONGULIA MD

Original Issue Date

11/07/1997

Effective Date

11/07/1997

Expiration Date

07/31/2005

City

BARRINGTON

State

Zip

60010

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006