MICHELLE T BASS GOLDIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036474

License Status

EXPIRED

Business

First Name

MICHELLE

Middle

Last Name

BASS GOLDIN

Business Name

MICHELLE T BASS GOLDIN

Original Issue Date

06/06/1997

Effective Date

06/06/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006