REGINA G GREENBAUM Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036058

License Status

CANCELLED

Business

First Name

REGINA

Middle

Last Name

GREENBAUM

Business Name

REGINA G GREENBAUM

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2008

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006