GRACE TANDOC MARTIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036622

License Status

EXPIRED

Business

First Name

GRACE

Middle

TANDOC

Last Name

MARTIN

Business Name

GRACE TANDOC MARTIN

Original Issue Date

06/11/1997

Effective Date

06/11/1997

Expiration Date

06/21/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006