MYRIAH W MATHISEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039232

License Status

EXPIRED

Business

First Name

MYRIAH

Middle

Last Name

MATHISEN

Business Name

MYRIAH W MATHISEN

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

09/22/2006