TERI L CARLSON Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109787

License Status

NOT RENEWED

Business

First Name

TERI

Middle

Last Name

CARLSON

Business Name

TERI L CARLSON

Original Issue Date

07/25/2003

Effective Date

07/25/2003

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

03/15/2013