SUSAN MARIE IMWALLE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037576

License Status

EXPIRED

Business

First Name

SUSAN

Middle

MARIE

Last Name

IMWALLE

Suffix

Business Name

SUSAN MARIE IMWALLE MD

Original Issue Date

06/17/1998

Effective Date

06/17/1998

Expiration Date

06/16/1999

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006