SIMON ST JOHN PRENDIVILLE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102436

License Status

NOT RENEWED

Business

First Name

SIMON

Middle

ST JOHN

Last Name

PRENDIVILLE

Suffix

Business Name

SIMON ST JOHN PRENDIVILLE MD

Original Issue Date

05/08/2000

Effective Date

05/08/2000

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006