FARAH S GHOUSE Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047512

License Status

EXPIRED

Business

First Name

FARAH

Middle

Last Name

GHOUSE

Business Name

FARAH S GHOUSE

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

06/20/2007

City

OAK PARK

State

Zip

60302

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/03/2007