GRACE CHONG Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052670

License Status

CANCELLED

Business

First Name

GRACE

Last Name

CHONG

Business Name

GRACE CHONG

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

12/29/2009