MIRIAM LOUISE HANSON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046354

License Status

CANCELLED

Business

First Name

MIRIAM

Middle

LOUISE

Last Name

HANSON

Suffix

Business Name

MIRIAM LOUISE HANSON MD

Original Issue Date

06/16/2003

Effective Date

06/16/2003

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006