CHANELE M BURGUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101216

License Status

NOT RENEWED

Business

First Name

CHANELE

Middle

Last Name

BURGUN

Suffix

Business Name

CHANELE M BURGUN MD

Original Issue Date

09/03/1999

Effective Date

09/03/1999

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60656

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006