EVANGELINE TAN CO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012690

License Status

EXPIRED

Business

First Name

EVANGELINE TAN

Last Name

Business Name

EVANGELINE TAN CO

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

07/01/1983

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006