GREGORY LEE GOETZ DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109053

License Status

NOT RENEWED

Business

First Name

GREGORY

Middle

LEE

Last Name

GOETZ

Suffix

Business Name

GREGORY LEE GOETZ DO

Original Issue Date

04/21/2003

Effective Date

04/21/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006