HAROLD W GOFORTH Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125037586

License Status

CANCELLED

Business

First Name

HAROLD

Middle

Last Name

GOFORTH

Business Name

HAROLD W GOFORTH

Original Issue Date

05/08/1998

Effective Date

05/08/1998

Expiration Date

06/15/2002

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006