DENA J GOST Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036766

License Status

EXPIRED

Business

First Name

DENA

Middle

Last Name

GOST

Business Name

DENA J GOST

Original Issue Date

06/16/1997

Effective Date

06/16/1997

Expiration Date

06/30/2000

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006