THOMAS J TAKACH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021435

License Status

EXPIRED

Business

First Name

THOMAS

Middle

Last Name

TAKACH

Business Name

THOMAS J TAKACH

Original Issue Date

06/24/1987

Effective Date

06/24/1987

Expiration Date

06/22/1990

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006