KENNETH J MINTZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019167

License Status

EXPIRED

Business

First Name

KENNETH J

Last Name

MINTZ

Suffix

Business Name

KENNETH J MINTZ MD

Original Issue Date

05/19/1986

Effective Date

05/19/1986

Expiration Date

06/27/1989

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006