IRA DE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022735

License Status

EXPIRED

Business

First Name

IRA

Last Name

Suffix

Business Name

IRA DE MD

Original Issue Date

06/14/1988

Effective Date

06/14/1988

Expiration Date

07/01/1991

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006