MIA M SONG Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036104848

License Status

ACTIVE

Business

First Name

MIA

Middle

Last Name

SONG

Business Name

MIA M SONG

Original Issue Date

05/29/2001

Effective Date

04/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60602

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2023