BEATRICE UTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040407

License Status

CANCELLED

Business

First Name

BEATRICE

Last Name

UTA

Suffix

Business Name

BEATRICE UTA MD

Original Issue Date

08/01/1999

Effective Date

08/01/1999

Expiration Date

07/31/2002

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006