EDWARD S GORDON Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036368

License Status

CANCELLED

Business

First Name

EDWARD

Middle

Last Name

GORDON

Business Name

EDWARD S GORDON

Original Issue Date

05/29/1997

Effective Date

05/29/1997

Expiration Date

06/30/2000

City

LAGRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006