LARRY TIM WONG DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040105

License Status

EXPIRED

Business

First Name

LARRY

Middle

TIM

Last Name

WONG

Suffix

Business Name

LARRY TIM WONG DO

Original Issue Date

06/21/1999

Effective Date

06/21/1999

Expiration Date

06/20/2004

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006