STACI M COHEN Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036099025

License Status

INACTIVE

Business

First Name

STACI

Middle

Last Name

COHEN

Business Name

STACI M COHEN

Original Issue Date

09/10/1998

Effective Date

09/10/1998

Expiration Date

07/31/1999

City

OAK PARK

State

Zip

60302

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006