MARK D THIEBERG Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025598

License Status

EXPIRED

Business

First Name

MARK

Middle

Last Name

THIEBERG

Business Name

MARK D THIEBERG

Original Issue Date

06/20/1990

Effective Date

06/20/1990

Expiration Date

06/19/1993

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006