MAGALI J FONTAINE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030475

License Status

EXPIRED

Business

First Name

MAGALI

Middle

Last Name

FONTAINE

Business Name

MAGALI J FONTAINE

Original Issue Date

06/25/1993

Effective Date

06/25/1993

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

05/08/2013