SUSAN M LAGE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029338

License Status

EXPIRED

Business

First Name

SUSAN M

Last Name

LAGE

Business Name

SUSAN M LAGE

Original Issue Date

05/05/1993

Effective Date

05/05/1993

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006