MIMI EVADNE VAN DER LEDEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030981

License Status

EXPIRED

Business

Title

First Name

MIMI

Middle

EVADNE

Last Name

VAN DER LEDEN

Business Name

MIMI EVADNE VAN DER LEDEN MD

Original Issue Date

05/04/1994

Effective Date

05/04/1994

Expiration Date

06/30/1997

City

BERWYN

State

Zip

60402

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006