ALEXANDRA PAE SONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039287

License Status

CANCELLED

Business

Title

First Name

ALEXANDRA

Middle

PAE

Last Name

SONG

Business Name

ALEXANDRA PAE SONG MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

02/11/2004

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006