LISA A MARTIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035901

License Status

EXPIRED

Business

First Name

LISA

Middle

Last Name

MARTIN

Business Name

LISA A MARTIN

Original Issue Date

05/09/1997

Effective Date

05/09/1997

Expiration Date

06/23/2000

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006