MATTHEW J LICKERMAN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040887

License Status

EXPIRED

Business

First Name

MATTHEW

Middle

Last Name

LICKERMAN

Business Name

MATTHEW J LICKERMAN

Original Issue Date

06/21/2000

Effective Date

06/21/2000

Expiration Date

06/20/2003

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006