MICHAEL T GILLAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034330

License Status

EXPIRED

Business

First Name

MICHAEL

Middle

Last Name

GILLAM

Suffix

Business Name

MICHAEL T GILLAM MD

Original Issue Date

05/13/1996

Effective Date

05/13/1996

Expiration Date

06/17/1999

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006