DOUGLAS MICHAEL CARPENTER Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033939

License Status

EXPIRED

Business

First Name

DOUGLAS MICHAEL

Last Name

CARPENTER

Business Name

DOUGLAS MICHAEL CARPENTER

Original Issue Date

09/19/1995

Effective Date

09/19/1995

Expiration Date

09/18/1998

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006