W RAFER LEACH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036553

License Status

EXPIRED

Business

First Name

W RAFER

Last Name

LEACH

Business Name

W RAFER LEACH

Original Issue Date

06/10/1997

Effective Date

06/10/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006