KATHLEEN CARROLL MOLINE DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049243

License Status

CANCELLED

Business

First Name

KATHLEEN

Middle

CARROLL

Last Name

MOLINE

Suffix

Business Name

KATHLEEN CARROLL MOLINE DO

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2008

City

WHEATON

State

Zip

60187

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006