PAUL FOCKENS Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000178

License Status

CANCELLED

Business

First Name

PAUL

Last Name

FOCKENS

Business Name

PAUL FOCKENS

Original Issue Date

10/25/2002

Effective Date

10/25/2002

Expiration Date

05/21/2003

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/23/2006