MEREDITH W COUSIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039681

License Status

EXPIRED

Business

First Name

MEREDITH

Middle

Last Name

COUSIN

Business Name

MEREDITH W COUSIN

Original Issue Date

06/28/1999

Effective Date

06/28/1999

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

09/22/2006