COLLEEN PATRICIA DOHERTY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054401

License Status

CANCELLED

Business

Title

First Name

COLLEEN

Middle

PATRICIA

Last Name

DOHERTY

Business Name

COLLEEN PATRICIA DOHERTY MD

Original Issue Date

06/24/2008

Effective Date

06/24/2008

Expiration Date

06/23/2011

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/13/2008