GREGG H SMALL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125019918

License Status

EXPIRED

Business

First Name

GREGG H

Last Name

SMALL

Business Name

GREGG H SMALL

Original Issue Date

06/30/1986

Effective Date

06/30/1986

Expiration Date

07/01/1989

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006