KENT MARION POTTER DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106181

License Status

NOT RENEWED

Business

First Name

KENT

Middle

MARION

Last Name

POTTER

Suffix

Business Name

KENT MARION POTTER DO

Original Issue Date

01/31/2002

Effective Date

01/31/2002

Expiration Date

07/31/2005

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006