SUSAN K DUDERSTADT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125029670

License Status

EXPIRED

Business

First Name

SUSAN K

Last Name

DUDERSTADT

Business Name

SUSAN K DUDERSTADT

Original Issue Date

05/15/1993

Effective Date

05/15/1993

Expiration Date

06/20/1996

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006