TRACY W CANNON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125032572

License Status

EXPIRED

Business

First Name

TRACY

Middle

Last Name

CANNON

Business Name

TRACY W CANNON

Original Issue Date

05/18/1995

Effective Date

05/18/1995

Expiration Date

06/30/1998

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

09/22/2006