SALLY Q TAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030651

License Status

EXPIRED

Business

First Name

SALLY Q

Last Name

TAN

Business Name

SALLY Q TAN

Original Issue Date

07/15/1993

Effective Date

07/15/1993

Expiration Date

07/14/1995

City

OAK LAWN

State

Zip

60453

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006