DIANA M TRACY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036345

License Status

EXPIRED

Business

First Name

DIANA

Middle

Last Name

TRACY

Suffix

Business Name

DIANA M TRACY MD

Original Issue Date

05/27/1997

Effective Date

05/27/1997

Expiration Date

06/30/2005

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006