CONSTANCE D SHABAZZ Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019465

License Status

EXPIRED

Business

First Name

CONSTANCE D

Last Name

SHABAZZ

Business Name

CONSTANCE D SHABAZZ

Original Issue Date

06/18/1986

Effective Date

06/18/1986

Expiration Date

06/26/1990

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006