SUSAN M SELBACH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026414

License Status

EXPIRED

Business

First Name

SUSAN M

Last Name

SELBACH

Suffix

Business Name

SUSAN M SELBACH MD

Original Issue Date

05/03/1991

Effective Date

05/03/1991

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006