PHILIPPE F BACKELJAUW Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021837

License Status

EXPIRED

Business

First Name

PHILIPPE

Middle

Last Name

BACKELJAUW

Business Name

PHILIPPE F BACKELJAUW

Original Issue Date

05/01/1988

Effective Date

05/01/1988

Expiration Date

05/01/1991

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/22/2006