THERESE MARIE HEENAN DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049451

License Status

CANCELLED

Business

Title

First Name

THERESE

Middle

MARIE

Last Name

HEENAN

Business Name

THERESE MARIE HEENAN DO

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

TINLEY PARK

State

Zip

60477

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006