MARY B FAUSONE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016798

License Status

EXPIRED

Business

First Name

MARY B

Last Name

FAUSONE

Suffix

Business Name

MARY B FAUSONE MD

Original Issue Date

06/01/1984

Effective Date

06/01/1984

Expiration Date

07/01/1986

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006