EMILY CATHERINE BELLAVANCE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120319

License Status

NOT RENEWED

Business

First Name

EMILY

Middle

CATHERINE

Last Name

BELLAVANCE

Business Name

EMILY CATHERINE BELLAVANCE

Original Issue Date

03/13/2008

Effective Date

08/15/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2011