TERRY A CONKLIN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044601

License Status

EXPIRED

Business

First Name

TERRY

Middle

Last Name

CONKLIN

Business Name

TERRY A CONKLIN

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/22/2006