MICHELLE A GAVIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047524

License Status

CANCELLED

Business

First Name

MICHELLE

Middle

Last Name

GAVIN

Suffix

Business Name

MICHELLE A GAVIN MD

Original Issue Date

06/21/2004

Effective Date

06/21/2004

Expiration Date

01/08/2009

City

NORTHBROOK

State

Zip

60062

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006