STEPHANIE A BOOTH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041394

License Status

EXPIRED

Business

First Name

STEPHANIE

Middle

Last Name

BOOTH

Business Name

STEPHANIE A BOOTH

Original Issue Date

06/20/2000

Effective Date

06/20/2000

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Rheumatology

Ever Disciplined

LastModifiedDate

09/22/2006