STACY FERN TITLE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125026944

License Status

EXPIRED

Business

First Name

STACY FERN

Last Name

TITLE

Business Name

STACY FERN TITLE

Original Issue Date

05/28/1991

Effective Date

05/28/1991

Expiration Date

06/18/1994

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006