TINA S CARROLL Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125028137

License Status

EXPIRED

Business

First Name

TINA

Middle

Last Name

CARROLL

Business Name

TINA S CARROLL

Original Issue Date

05/18/1992

Effective Date

05/18/1992

Expiration Date

06/23/1995

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006