PANY DECOSSARD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041889

License Status

EXPIRED

Business

First Name

PANY

Last Name

DECOSSARD

Suffix

Business Name

PANY DECOSSARD MD

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006