CYNTHIA JANE PROVOW MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125048842

License Status

EXPIRED

Business

First Name

CYNTHIA

Middle

JANE

Last Name

PROVOW

Suffix

Business Name

CYNTHIA JANE PROVOW MD

Original Issue Date

12/10/2004

Effective Date

12/10/2004

Expiration Date

12/09/2007

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

01/03/2008