GRACE TANDOC MARTIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102041

License Status

NOT RENEWED

Business

First Name

GRACE

Middle

TANDOC

Last Name

MARTIN

Business Name

GRACE TANDOC MARTIN

Original Issue Date

02/29/2000

Effective Date

02/29/2000

Expiration Date

07/31/2005

City

WESTCHESTER

State

Zip

60154

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006