CONSTANCE O CLEAVES Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047402

License Status

EXPIRED

Business

First Name

CONSTANCE

Middle

Last Name

CLEAVES

Business Name

CONSTANCE O CLEAVES

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

07/03/2007