TRACEY L CORNELLA CARLSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028009

License Status

EXPIRED

Business

First Name

TRACEY L

Last Name

CORNELLA CARLSON

Business Name

TRACEY L CORNELLA CARLSON

Original Issue Date

05/12/1992

Effective Date

05/12/1992

Expiration Date

06/30/1995

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006