ELIZABETH A WANTUCH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053422

License Status

CANCELLED

Business

First Name

ELIZABETH

Middle

Last Name

WANTUCH

Suffix

Business Name

ELIZABETH A WANTUCH MD

Original Issue Date

06/22/2007

Effective Date

06/22/2007

Expiration Date

06/21/2010

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

01/27/2011