JIE SONG MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125051878

License Status

CANCELLED

Business

First Name

JIE

Last Name

SONG

Suffix

Business Name

JIE SONG MD

Original Issue Date

06/24/2009

Effective Date

06/24/2009

Expiration Date

06/23/2010

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

09/01/2009