GENIE ELLEN ROOSEVELT MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024735

License Status

EXPIRED

Business

First Name

GENIE ELLEN

Last Name

ROOSEVELT

Suffix

Business Name

GENIE ELLEN ROOSEVELT MD

Original Issue Date

05/05/1990

Effective Date

05/05/1990

Expiration Date

06/19/1993

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006