SPENCER THOMAS BERTRAM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041913

License Status

CANCELLED

Business

First Name

SPENCER

Middle

THOMAS

Last Name

BERTRAM

Suffix

Business Name

SPENCER THOMAS BERTRAM MD

Original Issue Date

06/24/2000

Effective Date

06/24/2000

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006