DOUGLAS J MOGLE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125012924

License Status

EXPIRED

Business

First Name

DOUGLAS

Middle

Last Name

MOGLE

Business Name

DOUGLAS J MOGLE

Original Issue Date

06/17/1981

Effective Date

06/17/1981

Expiration Date

07/01/1983

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006