JUSTIN RAY HODGE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047317

License Status

CANCELLED

Business

Title

First Name

JUSTIN

Middle

RAY

Last Name

HODGE

Business Name

JUSTIN RAY HODGE MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2009

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

11/19/2008