ANDREW J KAVANAUGH-BLACK Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036108517

License Status

INACTIVE

Business

First Name

ANDREW

Middle

Last Name

KAVANAUGH-BLACK

Business Name

ANDREW J KAVANAUGH-BLACK

Original Issue Date

01/31/2003

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014