SUSAN G BURLACOFF Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029151

License Status

EXPIRED

Business

First Name

SUSAN

Middle

Last Name

BURLACOFF

Business Name

SUSAN G BURLACOFF

Original Issue Date

09/21/1992

Effective Date

09/21/1992

Expiration Date

09/20/1995

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006