MARY M BEAUCHAMP Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042679

License Status

EXPIRED

Business

First Name

MARY

Middle

Last Name

BEAUCHAMP

Business Name

MARY M BEAUCHAMP

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2004

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Otolaryngology

Ever Disciplined

LastModifiedDate

09/22/2006