PHENU ZACHARIAH DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047419

License Status

EXPIRED

Business

First Name

PHENU

Last Name

ZACHARIAH

Suffix

Business Name

PHENU ZACHARIAH DO

Original Issue Date

06/28/2004

Effective Date

06/28/2004

Expiration Date

06/27/2007

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/01/2008