ANDREW J KAVANAUGH-BLACK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041481

License Status

EXPIRED

Business

First Name

ANDREW

Middle

Last Name

KAVANAUGH-BLACK

Business Name

ANDREW J KAVANAUGH-BLACK

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006