DARLENE E FOGG Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036444

License Status

CANCELLED

Business

First Name

DARLENE

Middle

Last Name

FOGG

Business Name

DARLENE E FOGG

Original Issue Date

06/05/1997

Effective Date

06/05/1997

Expiration Date

06/21/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006