STEPHANIE M POUCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052403

License Status

CANCELLED

Business

First Name

STEPHANIE

Middle

Last Name

POUCH

Suffix

Business Name

STEPHANIE M POUCH MD

Original Issue Date

06/24/2007

Effective Date

06/24/2007

Expiration Date

06/23/2010

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

04/27/2007