RICHARD A PETRAK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017147

License Status

EXPIRED

Business

First Name

RICHARD A

Last Name

PETRAK

Suffix

Business Name

RICHARD A PETRAK MD

Original Issue Date

06/22/1984

Effective Date

06/22/1984

Expiration Date

06/25/1986

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006