JULIE LYNN PROVIDENTI Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125031070

License Status

EXPIRED

Business

First Name

JULIE LYNN

Last Name

PROVIDENTI

Business Name

JULIE LYNN PROVIDENTI

Original Issue Date

05/11/1994

Effective Date

05/11/1994

Expiration Date

06/20/1995

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006