MIRA V LEE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034736

License Status

EXPIRED

Business

First Name

MIRA

Middle

Last Name

LEE

Business Name

MIRA V LEE

Original Issue Date

05/28/1996

Effective Date

05/28/1996

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006