KIMBERLY A DETTLOFF MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025320

License Status

EXPIRED

Business

First Name

KIMBERLY A

Last Name

DETTLOFF

Suffix

Business Name

KIMBERLY A DETTLOFF MD

Original Issue Date

06/06/1990

Effective Date

06/06/1990

Expiration Date

06/30/1993

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006