MARK P VANDEN BOSCH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018803

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

VANDEN BOSCH

Business Name

MARK P VANDEN BOSCH

Original Issue Date

06/26/1985

Effective Date

06/26/1985

Expiration Date

07/01/1988

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006