HENRY J GOOLSBY III Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017694

License Status

EXPIRED

Business

First Name

HENRY

Middle

Last Name

GOOLSBY III

Business Name

HENRY J GOOLSBY III

Original Issue Date

10/03/1984

Effective Date

10/03/1984

Expiration Date

07/01/1986

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006