ANN DECLUE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017785

License Status

EXPIRED

Business

Title

First Name

ANN

Last Name

DECLUE

Business Name

ANN DECLUE MD

Original Issue Date

04/11/1985

Effective Date

04/11/1985

Expiration Date

03/20/1987

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006