STACI M COHEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034861

License Status

EXPIRED

Business

First Name

STACI

Middle

Last Name

COHEN

Business Name

STACI M COHEN

Original Issue Date

06/05/1996

Effective Date

06/05/1996

Expiration Date

06/21/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006